Speaking of Sex: Be H.E.A.R.D.!

by Marloe EschSurvivorJune 29, 2020View more posts from Marloe Esch

Ready for a quick challenge? Ok, repeat after me:

Vulva.

Orgasm.

Penis. 

So, did you do it? I’m serious!

Ok, so everyone’s comfort level talking about sex is different, and you might feel a little weird about saying the words out loud. That’s totally normal!  Chances are, you haven’t really had much practice communicating about the sexual bits of your life or your body.  Most of us have never been given very detailed roadmaps on how to successfully navigate these kinds of discussions, so it makes sense that the idea of doing so is nerve-wracking.

But often, such conversations are an important and necessary part of addressing any worries, concerns, or questions you might have about your sex life.  Cancer can change how our bodies look or how they respond to sexual touch, how we feel about our appearance, and our interest in being sexual.  And yeah, bringing up any of these sensitive topics with your partner can feel really awkward.  But is it impossible?  Of course not!

So how do you begin?  Well, when it comes to talking about sex, following a few key tips and tricks can help open the door to a productive dialogue with your honey.  Be H.E.A.R.D.!

Honesty really is the best policy when it comes to conversations about sex, but it might feel a little tricky finding a way to do this.  Many of us avoid bringing up our concerns with our partners because we don’t want to hurt their feelings or make them feel embarrassed. Maybe we are afraid they will be offended or they won’t want to talk about it.

Even though it may feel safer not to say anything, ignoring or avoiding what’s on your mind usually doesn’t help you feel better or resolve the problem, and it definitely doesn’t give your partner an opportunity to lend support!  Instead, being truthful allows them to be a part of the solution.  If they know what’s bothering you, they can provide reassurance and brainstorm ideas on how to work together to address the issue.

But… what’s the best way to be honest?  First, take a deep breath.  Remember that you partner wants to help with things that are troubling you.  Next, using “I” statements when sharing how you are feeling and what you are thinking can help get your point across without your partner feeling blamed or defensive.  You might try something like:

  • “I’ve noticed that I/my/our….”
  • “I have been thinking about…”
  • “Sometimes I feel ____ when I/you/we…”

Being honest is also an important part of sharing your experiences with new and potential partners.  If you are single and dating or in a new relationship, you might be struggling with when and how to address some of the things you want this person to know. Honesty is wayyy better than trying to hide something or living in fear of being found out or rejected, but that doesn’t always make it easier.  Disclosing your cancer status, and any residual ramifications (sexual or otherwise), is a discussion worthy of much more than a paragraph, so keep an eye out for an article dedicated to this topic in a future issue of Elephants and Tea!

Environment is everything.  Since sex is a sensitive subject, a little planning can go a long way in helping you feel calm and collected.  Choosing when and where you want to talk and considering what you’d like to say beforehand is a good idea.  Plan to talk somewhere outside of the bedroom when you and your partner are relaxed (and fully clothed!), like over coffee at the kitchen table.  Make sure that you have privacy, and that you’ve set aside plenty of time without interruptions.

If possible, try to have these conversations face-to-face.  It may feel a little overwhelming, but it’s usually best to talk in-person, because there’s just too much room for misinterpretation when you’re trading texts over a screen (I mean…trying to decipher a million emojis can get confusing, right?  And those non-responses are excruciating!).  Think about writing down what you want to say, and practicing a little bit (saying those words out loud, remember?).  If a letter explaining how you feel is what you are most comfortable with, you can use that to get things started.  Just be sure that you have a plan for following up with your partner’s thoughts, because their feedback is important.

If you find yourself continually putting off the discussion, set a date and time on your calendar to hold yourself accountable.  Making this a priority by setting aside time to talk shows your partner that it matters to you.

Ask questions. Communication is a two-way street, ya’ll.  While it’s important to convey your message in a way that your partner will understand, you also need to listen and make an effort to see things from their perspective, too.  Give them a chance to chime in with their thoughts so you know where they are coming from. Approach their point-of-view with curiosity:

  • “What do you think about…?”
  • “How does it feel when…?”
  • “What have you noticed about when we…?”

Asking open-ended questions can get them thinking and is more likely to elicit insightful responses.  If they have some of the same concerns you do, you can work together and not feel so alone!  They may also help you see things differently.

Respect, Reflect, and Reinforce the good. Part of asking questions and actively listening includes being respectful of the stuff your partner shares with you. It takes bravery to be open about something as intimate as sex.  Talking about it can make your partner feel vulnerable and exposed, just like you might be feeling.  When you are exchanging thoughts, validate their feelings and let them know that what they say is important to you.  Reflect back what you heard from them, and ask for clarification:

  • “It sounds like ____, did I get that right?”
  • “I can understand how you might see things that way.”
  • “I never considered that before, but it makes sense.”
  • “That’s an interesting point.  Can you tell me more about…?”

You can also encourage them to reflect back what they’ve understood from your words:

  • “This was hard for me to say and I just want to make sure I said it clearly.  Can you share with me what you heard?”

Sometimes when we are talking about things that have to do with our relationships, what we say or how we say it may be interpreted by our partner as criticism or judgement, even if we don’t mean it that way.  Along with “I” statements, remembering to reinforce the good in your relationship and reframing things in a positive light can help prevent hurt feelings.  You might say things like:

  • “I really miss ____!  Let’s find a new way to enjoy…”
  • “I love when you/we ____, but I’ve noticed that ….”
  • “Remember when we used to _____? Let’s try ….”

Details, details, details!  How many frank conversations about sex have you had with a partner?  I’m talking, like, an exchange of full sentences and the use of proper terminology.

Perhaps up until this point, you’ve relied mostly on non-verbal cues and the occasional “ooh” or “aah” to get your point across (probably with varying levels of success, I’d bet).  When it comes to sexual needs, wants, and worries, we often depend on very ineffective ways of communicating.  That is, if we even communicate at all!  Many of us rely on false assumptions, like the belief that our partner should not only just know what’s wrong, but also how to fix it!  Realistically, it’s not fair to blame our partners for failing to interpret our thoughts; such impossible expectations only result in frustration. Mind-reading is not a thing!  Instead, it’s all about sharing the details.

Do you need some snuggle time without the expectation of more?  Not ready for sharing a certain part of your body yet?  Has there been a change in the type/amount/duration of sexual touch that works for you?  Do you want to try a personal lubricant?  Would it be helpful to hear all the things they love about you?  Say so!  Being specific about how you feel and what you need eliminates the guessing game and lets you both focus on an action plan for the problem.  If you have ideas about what could be done to help, share them.  This can alleviate your partner’s fears about doing or saying the wrong thing.

Don’t be afraid to state what you might feel is obvious.  Chances are that what seems obvious to you may not be quite so clear to your partner.  They will appreciate the specifics!

  • “I would really like it if….”
  • “I’ve noticed that I need more/less….”
  • “Sometimes it just feels good if you….”
  • “I’m not up for ___ tonight, but do you think we could ___?”

Be H.E.A.R.D., and Then…

Sometimes, a conversation is all that’s needed to clear up a concern or get a question answered.  But often, speaking up is just the first step to figuring things out.  If you find that you need some more help to resolve a problem, there are lots of resources available you can tap into.  Your cancer center may have counselors who can help you and your partner communicate effectively about difficult stuff.  You can also look up counselors or therapists in your area that are certified in sexual issues on the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) website.  More ideas on how to talk about sex can be found on the web and in books too; check out some of the resources below.  And as always, asking your healthcare team for help is a great place to start.

 

What’s Up, Doc?

What about that really embarrassing question you wanted to ask your provider about?  You know, that thing that happened the last time you tried to [insert sexual act here]? First of all, it’s probably really not as embarrassing as you think it is.  And secondly, you are not alone!  Sexual questions and concerns are super common for cancer survivors of all ages.

Healthcare professionals can give you reassurance as to what’s normal and help you understand what to expect during and after treatment.  They can also give you ideas for common problems, help trouble-shoot more specific symptoms or issues, and provide resources and referrals to other experts in sexual and reproductive health.

Ideally, your doctor or nurse will be taking responsibility for checking in with you regularly about your sexual health at your appointments. In reality, though, the difficult task of bringing it up might be left to you!  Here are some ideas on how to get the ball rolling:

  • Come prepared. Bring a list of questions that you can read from at your appointment, if necessary.
  • It’s ok to request to talk with just your provider present, or to ask for a more private space to have a conversation if needed.
  • Bring sex up just as you would any other concern that you have: “I’m having trouble with fatigue, nausea, and sexual [touch/sensation/arousal/desire/etc] has changed for me.”
  • Be as specific as you can when explaining an issue or asking a question.  This helps your doctor or nurse understand exactly what you needs are or what kind of information you are looking for (practice those words out loud! vulva! ear! penis! elbow!).
  • It might be easier to ask questions with your partner present…. or without!
  • Sometimes doctors or nurses use vague language, confusing euphemisms or super-scientific medical jargon to talk about sex.  If something they are saying is unclear, ask them to clarify or explain it in a different way.
  • Not sure who on your care team to approach?  Scope out the person that you feel most comfortable with first.  If they don’t know the answer, they can help you figure out who will.
  • If you are LGBTQ+, you might be wondering if it matters whether or not your healthcare team knows your gender identity or sexual orientation.  Sharing as much as you are comfortable with can be helpful so that everything they discuss and plan with you is relevant to your life and your needs.  However, you are never obligated to disclose this information, and either way, it should not change the care you receive.

 

Bibliography and Resources:

 


All of the posts written for Elephants and Tea are contributed by patients, survivors, caregivers and loved ones dealing with cancer.  If you have a story or experience you would like to share with the cancer community we would love to hear from you!  Please submit your idea at https://www.elephantsandtea.com/contact/submissions/.

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