Sexuality and Intimacy

Intimacy

“…Intimacy need not end with bone marrow failure disease. You may need to redefine your ways of expressing intimacy, and you may need to experiment because what worked before may no longer work after.” – Mayo Clinic Staff, 2003

What is the Impact of Bone Marrow Failure Disease on Sexuality and Intimacy?

A medical illness can present emotional challenges concerning life-style, independence and routine activities and can impact sexual function.

Intimacy and sexuality are not life or death issues, but are quality of life issues. Bone marrow failure disease may impact intimacy and sex drive from physical and psychological side effects of treatment. Emotional and medical stressors can impact sexual function. Medical illness can present emotional challenges concerning life-style, independence and routine activities and can impact sexual function.

Symptoms of Bone Marrow Failure Disease Can Affect Sexuality and Intimacy

Side Effects of Medication Used for Treating Bone Marrow Failure Disease Can Affect Sexuality and Intimacy

  • Immunosuppressive agents like anti-thymocyte globulin (ATG ) (ALG) can cause fatigue and hypertension
  • White cell growth factors like G-CSF (Neupogen® or Filgrastim®) can cause nausea/vomiting, muscle aches, fatigue, flu-like symptoms
  • GM-CSF Leukine® can cause bone pain, fatigue, nausea, flu-like symptoms
  • Immunomodulatory Agents like Lenalidomide (Revlimid®) can cause fatigue, nausea, joint pain
  • Hypomethlyating Agents like Azacitidine (Vidaza®) can cause nausea/vomiting, diarrhea, fatigue, fever
  • Red cell growth factors like Erythropoietin (Procrit® or Epogen®) can cause joint pain, headache
  • Prescribed medications to help with mood can also interfere with desire and sexual response. Narcotic drugs (morphine, dilaudid, codeine), antiemetics, sedatives and tranquilizers can be responsible for decreased libido and impaired potency. Smoking, alcohol and substance abuse use can also negatively affect libido.

What Can You Do?

  • Be aware of how the time of day impacts your libido.  Know when your energy is greatest throughout the day and when you are most refreshed.  Try taking any pain medication 1/2 - 1 hour before sexual activity. 
  • Your diagnosis may have changed how you look, but it does not have to change how you feel about yourself
  • Include good nutrition and exercise to help how you feel about yourself
  • Be patient with the physical effects, as you get well you will feel well and look better
  • Tell your partner how you feel about your intimate life and what you would like to change.Listen to your partner's point of view. Make an effort to communicate, and remember that problems before cancer don’t magically disappear during/after cancer. See a professional therapist to help work through road blocks    

Intimacy for Couples with Children

  • Schedule a night out for the kids on a regular basis
  • Be honest and express yourselves in front of your children
  • Find ways to connect with each child if you find that your activity level is limited

Where to Go for Help

Talking with your partner is almost always the first step in resolving any issue.  You can also turn to professionals for help.  Try your primary care doctor or hematologist/oncologist.  Who do you feel comfotable with?  You can also ask for referrals to mental health professionals - psychiatrists, psychologists, or social workers.

Remember that appropriate timing of activity may increase enjoyment of sex.  You need to communicate about your needs.  Consider other ways to feel more sensual/sexual.  Know that sex is not the only form of intimacy.

Patience and a sense of humor are essential as you adjust to your "new normal". Know that you are not alone and that you can work to change sexual and intimacy expectations from a “body thing” to a “mind thing”.