LET’S TALK ABOUT SEX: chronic illness and its impact on sexuality

Contemporary Sexuality, the newsletter published online by the American Association of Sex Educators, Counselors, and Therapists (AASECT, of which I’m a member), has posted in its latest issue an article that spotlights a little-discussed issue: “How Chronic Illness Can Affect Sexual Function.” I’m glad to read such a thorough and thoughtful consideration of the topic.

I have worked with a number of men who have been diagnosed with prostate cancer. That’s a situation that clearly, undeniably, and almost universally forces men to deal with sexual issues before, during, and after treatment. That’s an easy example. But I’ve also worked with people struggling with how to reclaim or manage their sexual feelings in relation to other health challenges — one woman who suffers crippling migraines and who wanted help keeping her erotic body alive even when the headaches erased virtually every ounce of recognizable libido; other women navigating the mysterious straits of menopause or post-childbirth sexuality.

The AASECT article by Steph Auteri focuses primarily on cancer patients but opens out to discuss people dealing with the full spectrum of health challenges and their impact on sexuality. Auteri, a sexologist and author, lists a number of not-so-obvious symptoms that can affect sexual functioning. A couple of other passages that stood out for me:

Dr. Sage Bolte, a sexuality and oncology counselor, points out that, “All chronic illnesses have this shared theme of grief and loss. And then, you’re tasked with establishing a new normal. What this means may change on a daily basis.”

Much of this is ignored when a patient is first diagnosed, partially because it doesn’t seem so important at the time, and partially because most medical providers don’t even think to bring it up. Dr. Anne Katz, who regularly gives lectures to oncology care providers, says, “Medical school and nursing school curricula are woefully inadequate when it comes to teaching about healthy sexuality. We need to ask our patients about their sexuality. Otherwise, they think either that it’s not important or that it’s taboo.”


“For practitioners, one of the greatest gifts they are going to give their patients is initiating that conversation,” says Bolte. At the very least, she says, they should be asking their patients if they’ve noticed any changes in sexual function since their diagnosis. “Once that conversation happens,” she says, “the sense of relief you see on their faces… they didn’t realize it was normal. They thought they would just have to deal with it. They thought it would always be painful, that they’d never want to have sex again. Having that conversation opens the floodgates of conversation no one else has been willing to have with them. It gives them permission to be sexual beings.”
You can read the whole article online here. Check it out and let me know what you think.