Experts used to think that the sexual response followed a linear process, where things happened in a specific order. It starts with the desire or feeling of wanting to have sex, followed by arousal (feeling physically excited), orgasm, and then resolution (feeling relaxed afterwards).

For some people (especially those with a high sex drive), the sexual response happens like this. But when you have lots of things to do, like taking care of kids, going to appointments, or feeling tired all the time, it can seem like there's no time or energy for sex. And following a cancer diagnosis or treatment, especially when you're stressed or not feeling well, the desire to have sex might disappear. Even after you start feeling better, it might take a long time for that desire to come back, maybe months or even years.

But the process isn’t always linear. Lots of people choose to have sex even if they’re not feeling a strong sexual desire. They may still choose to have sex because:

• they want to give back to their partner
• it’s a way to feel close and connected to their partner
• they want to feel sexual pleasure or tension release
• they want to feel desirable or attractive

Even if you’re not feeling excited about having sex, you can still accept an invitation to be sexual. You may find that you start to enjoy yourself. Many people can enjoy sex even if they don’t have an orgasm. Sometimes, it can be less stressful if you worry less about what some people assume is supposed to happen, like having an orgasm or penetration, and try to focus on enjoying the time with your partner.

Worrying about sex

Your brain is your most important sex organ. How people think about sex is very important. If someone starts to worry about sex, this can make it more challenging to get motivated to be sexual. People might start to avoid sex because:

• it’s very hard to get aroused or feel pleasure during sex
• they fear sex because of pain with intercourse
• they’re afraid they won’t be able to get an erection, become aroused, or have an orgasm
• they might think their partner is only trying to be close to them because they want sex

Sometimes people may start to resent their partner for asking for sex. When this starts to happen, it sets up negative expectations for sex. If this is happening to you and your partner, try talking about it. If it’s hard to start a talk about this, you can ask for help or support. The more positive a person’s expectations, the more likely they are to enjoy sex and want to have it again.

What is good sex?

When people are asked about what makes a sexual experience good, there are many answers including: both partners wanted to be there, each partner was focused the other, and there was enough time.

As you think about your sexual experiences, consider:

• The place: Where are you going to have sex? Do you have enough time so you don’t feel rushed?
• Feelings about yourself: Do you feel good about yourself? Are you sick, tired, or stressed? Are you scared or nervous?
• The relationship: Do you feel good about your relationship? How are you doing as a couple?

Remember, sex is more than just intercourse. It can include many different types of activities which may or may not lead to an orgasm:

• masturbation
• kissing for a long time
• touching each other with your hands
• using sex toys like a vibrator or dildo
• oral sex
• penis-vagina intercourse
• outercourse, which is when the genitals touch each other, but there’s no penetration
• anal sex
• full body massage

What if my body doesn’t respond the way it used to?

Sometimes, trying hard to get things back to the way they were before cancer can be very frustrating. After cancer, many things change. For example, you might have vaginal dryness or pain or changes in erectile function. You might also feel different about yourself. It helps to be open with your partner about the changes you’re going through and how they make you feel.

Because your body is different now, you may need different types of stimulation to feel good. What used to work well, might not work anymore. For example, if you enjoyed having your breasts touched before surgery, you might not feel things the same way after surgery and might not be comfortable having your breasts touched anymore. Or if you have erectile dysfunction, you might need to be touched harder or faster to reach an orgasm.

Talk about this with your partner. Try new ways to touch your partner to find out what works for you. Don’t feel pressured to always just have intercourse. You may need to try different kinds of touch (lighter, longer​, or with a vibrator) to get aroused. Being open to new ideas may help you have better sexual experiences.​