http://www.mayoclinic.com/health/cancer-treatment/CA00018

Feelings that can cause loss of libido

Cancer is a physical disease, but going through a cancer diagnosis and
treatment can be very emotional. You may worry about your future, stress
over your treatment decisions and find joy in the small triumphs in
overcoming your cancer. All of these emotions influence how you feel about
yourself and your attitude toward intimacy. Some common feelings that can
negatively affect your libido include:

Guilt
You may feel guilty because you feel previous sexual experiences caused
your cancer. Cancer can't be transmitted sexually. Although some cancers
are more likely in people who have human papillomavirus (HPV), which is
transmitted sexually, many people live with HPV and never develop cancer.
Other sexually transmitted viruses that put you at risk of cancer include
hepatitis C, HIV and Epstein-Barr virus.

Fear
You may fear that sexual activity can cause a recurrence of your cancer or
that you will pass your cancer on to your partner. Sexual activity has no
influence on whether you'll experience a cancer recurrence. Your doctor
can discuss your prognosis and chances for a cancer-free life. You can't
pass your cancer on to another person.

Depression
Sadness or feelings of worthlessness are common signs of depression, which
causes a loss of libido and decreases the pleasure you experience during
sex. People with cancer are more likely than others to experience
depression. Depression is treatable, so talk to your doctor about your
feelings.

Self-consciousness
Changes to your appearance after cancer treatment can make you feel
self-conscious. For instance, the loss of your hair from chemotherapy, the
loss of a limb, breast, or testicle, scars from surgery, and ostomies can
make you feel less attractive. Many people find that their partners aren't
as concerned about these changes as they are. Still, it takes time to
become comfortable with the changes in your appearance. Your doctor may
have suggestions to help you regain your self-confidence. Talk with other
cancer survivors for ideas on ways to make you feel more sexually
attractive.

Grief and loss
Feelings of grief and loss can result if you feel cancer treatment has
significantly changed your body. Some people might say they feel less
feminine or masculine. For instance, a woman who has a hysterectomy may
feel a sense of loss and perceive herself as less of a woman. A man may
feel he's less of a man if he has his testicles removed (orchiectomy). For
some people, treatments alter how they view themselves and make them very
dissatisfied with their bodies. Although some sense of grief and loss is
expected with the physical changes, you can and should feel satisfied with
your body and feel positive about yourself. Talk to your doctor about how
you feel. Ask him or her for a referral to a clinical health psychologist
if you have strong feelings of dissatisfaction with yourself and your
body.

Stress
Being diagnosed with cancer and beginning your treatment is stressful.
This makes it difficult to get into an intimate mood because your mind is
distracted. If you're in a relationship, stress can exacerbate any
pre-existing problems you may have had. Talk with your partner about how
you feel.

Anxiety
The thought of resuming sex after your cancer can cause anxiety. You might
be unsure of how you'll perform. If you have a partner, you might find
yourself avoiding all intimacy. If you're single, you might be hesitant to
date because you aren't sure how or when you'll reveal your cancer
experience to a new partner. Anxiety is common, and it may help to talk
through your feelings with your partner, your doctor or a clinical health
psychologist.

Consider your partner's feelings toward sex

Many times, cancer survivors say their partners go through cancer with
them — standing by them and supporting them from the first diagnosis
through the uncertainty of life after treatment. It's an emotional time
for your partner, too, and sometimes partners feel afraid or reluctant to
resume sex. Your partner may be afraid that he or she will hurt you or
that you'll interpret his or her advances as pressure to have sex. Your
partner's role as caregiver during your treatment can make him or her see
you as a vulnerable patient, rather than the partner you think of yourself
as.

In many cases, communication about how both of you feel can make
situations like these easier. But many couples didn't spend much time
discussing sex before, and adding cancer to the mix makes it all the more
difficult. Couples therapy may help you open the lines of communication
and better understand your situation.
What you can do to regain your libido

If you've experienced a loss of libido, you may feel alone. You might not
want to talk about your feelings, but you should. The problem won't
resolve on its own. It will take cooperation between you, your partner and
your health care team to ensure that you feel comfortable resuming sexual
activity. Consider trying to:

   * Talk with your doctor or nurse. If your doctor hasn't discussed
sexuality, take the lead. Your doctor or nurse can help you find resources
and refer you to a clinical health psychologist.
   * Talk with your partner. One of the best ways to improve libido is to
open the lines of communication between you and your partner. For
instance, your partner may fear hurting you during sex and may avoid
initiating sexual activity. You may believe your partner is no longer
interested in you. A conversation about the issue can clear the air and
restore emotional and physical intimacy.
   * Talk with other cancer survivors. People who have had your same
cancer and have endured your same treatment are likely experiencing the
same loss of libido. Look for other cancer survivors in support groups in
your area, or you may be more comfortable connecting with other survivors
on Internet message boards. Contact the American Cancer Society for
information.
   * Change your definition of sexual intimacy. Maybe you aren't ready
for sex. Talk about this with your partner and look for other ways you can
be intimate. Simply spending quality time together may help you reconnect
and slowly move toward resuming sexual intimacy.
   * Track your desire. You might think you've lost all interest in sex,
but you may have sexual thoughts throughout your day that you ignore. Make
a note of times during the day when you think about sex. If you find
certain times of the day or certain situations rouse your interest in sex,
use those cues to help put you in the mood.

Loss of libido is common after cancer treatment, but that doesn't mean you
can't regain the sexual intimacy you once enjoyed. Broaching the subject
with your doctor, partner or even members of a support group may help you
work through your emotions and enable you to resume a satisfying sexual
relationship.

Helpful link, but I wonder if any women have recommendations re:
Pelvic Radiation and Vaginal Penetration Pain remedies.

The website recommended a dialator.  My routine OB/GYN recommends
estrogen therapy.  (Declined HRT after Hysterectomy 4 years ago). I am
reluctant to go on estrogen therapy, especially when a possible side
effect in the package insert is cancer. : P
My rectal cancer resulted in a colo-analosmosis.

Any Help will be greatly appreciated.

Lynn