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Sexuality and intimate relationships

Along with the physical and emotional changes that can happen because of your illness, your sense of sexuality may also change. Many people feel a sense of contentment and wellbeing when they continue or restart a loving and close relationship.

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Expressing your sexuality and connecting emotionally is healthy. Being unable to do this can affect your self-identity and relationships. Your sense of sexuality influences how you view yourself. It can be expressed through appearance, touch, roles and relationships. And it’s generally accepted that we need to communicate with each other and receive love. This can be done in a variety of ways.

If you’re in a close relationship, how you choose to express your sexuality depends on your individuality, relationship and social and cultural beliefs. Sex is a part of sexuality some consider essential. But for different people it can mean different things. For some people it’s about connection and joy, others see it as an obligation to their partner and for others it’s an escape or form of emotional release.

When you’re ill there are many factors that can prevent you from continuing your relationship as usual or change how you feel about your sexuality.  You may feel differently about having a physical relationship with your partner.

If you’re single or not in a long-term relationship, your illness or treatments may cause might put you off starting a new relationship.

Health and treatments – physical barriers

Your illness, medical treatments for it and physical environment can affect your expression of your sexuality, or may make it difficult for you to continue a physical relationship with a partner. Some factors could include:

  • tiredness and nausea
  • body-image and body-confidence
  • sexual performance
  • treatments and side effects
  • control of bodily functions
  • lack of privacy
  • shared rooms
  • staff intrusion
  • single beds

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Healthcare professionals – communication barriers

You may find that your doctor, nurse or other professionals in your care team don’t discuss sexuality and intimacy with you.

This might be because they:

  • feel uncomfortable with the topic
  • think other aspects of illness are more important
  • lack knowledge about appropriate, effective ways to promote the expression of sexuality and intimacy

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Making sure you get advice

Not talking about sexuality can lead to distress, feelings of isolation and a sense that your needs aren’t valid. Intimacy concerns are relevant at every age, for any sexual orientation and at any stage in life.

In the later stages of illness, quality of life becomes very important. You and your partner should be given the right care and attention. If you’ve previously enjoyed a close sexual relationship, sexual intimacy may continue to be part of your relationship, even at the end of life.

Bring up the topic with healthcare professionals if you would like to talk about it and be given advice. Nurses may be able to encourage discussion and information sharing between you and your partner. Or you could ask to be referred to someone else if the professional you speak to doesn’t have the right knowledge.

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Your own feelings about sex

You may find that you no longer feel like having a sexual relationship. Reasons why you might feel differently include:

  • changes in the way you relate to your partner, for example if they are caring for you
  • changes in your body-image and self-image
  • depression
  • anxiety
  • difficulty communicating worries and concerns
  • side effects of treatment, like fatigue, nausea, pain and oedema
  • fear of pain

Your partner might be treating you very delicately now you’re ill and may be frightened of causing you any pain. They may find it difficult to switch roles after caring for you and may also have little energy because of the physical and emotional demands of caring.

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Feeling more confidence in your appearance

You might like to try the free services of an organisation called Look good, feel better   which offers workshops and advice to help you feel more confident about how you look.

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Talking to your partner about sex

For some people, it’s unusual or difficult to talk about sexual relationships. Others may try to avoid bringing up the subject if they think it may cause an argument. But if you feel unable to have sex either physically or psychologically, it’s better to talk to your partner so that they can understand how you’re feeling. Don’t hide up your feelings and worry about it alone.

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Stages you may experience – physical and sexual interaction

As your illness progresses from early stages to treatment and post-treatment, your level of sexual interaction is likely to decrease and then may return to normal.

In the palliative or terminal stage, physical changes may have an effect. Psychological changes may too.  You may stop having sex completely or you may find yourself becoming more sexually active. It depends on you and it’s different for everyone.

Towards the end of life, a range of different needs may be experienced, including:

  • pleasure
  • grief
  • love
  • relaxation
  • distraction
  • painkilling
  • affirmation
  • anger

These needs can change the meaning and purpose of your physical and sexual relationship with your partner.

Your need for physical closeness, to touch and be touched, may become more important to you in terms of quality of life towards the end of life.

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Alternative ways to connect

Intimacy can be achieved in many different ways. You can still be close to your partner without having an active sex life. Touch can be very comforting and soothing. Massage, or simply lying close together, can connect you intimately.

Other ways to bond with your partner include listening to beautiful music that you both enjoy, watching a favourite film, sharing a delicious meal that you’ve both prepared or reading a passage of literature or a poem you both like together.

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Changes you may experience – emotional connection

Every relationship is unique, but you might find some of the experiences other people have had familiar.

  • Growing closer and stronger in your relationship, despite the emotional and physical impact of illness and treatments.
  • Moving apart as a couple, experienced through loss of spontaneity, lack of reciprocity and rejection.
  • Feeling closer and further apart in waves, connecting and disconnecting with each other.
  • Re-connecting emotionally as a couple.
  • Having different reactions to changes in your sexual relationship.
  • Enjoying a new level of intimacy through the intensity of the caring experience.

When one person is seriously ill, the dynamics of a couple are altered. Adjustment is needed as they meet the challenges that terminal illness brings.

Talk about concerns you might have about your relationship with your partner and try to understand what your symptoms mean for you both. You might like to contact a counsellor who can help you talk things through together, including talking about loss of sexual interaction if you’ve experienced this.

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Relationship advice

Talking about sexual and intimate matters doesn’t come easily to everyone so you might find it easier to speak to someone who you don’t know. This could be about the changes in your and your partner’s relationship and how this is affecting your sex life, or it could be about how you feel about your sexual identity.

Relate is an organisation offering relationship guidance   in England, Wales and Northern Ireland. You can talk to an adviser   by phone, email or using live online chat. Relate has local centres that offer counselling   and it also runs workshops   for couples and single people. You might find it useful to get relationship advice, whether you’re in a couple or are single.

In Scotland, Relationships Scotland   offers a similar service.

Talking to your doctor or nurse, or asking them to recommend counsellors, support groups or workshops may also be helpful for you.

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External websites

This page is for general information only. It's not intended to replace any advice from health or social care professionals. We suggest that you consult with a qualified professional about your individual circumstances. Read more about how our information is created and how it's used.

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