Communicating with Your Doctor About the Sexual Impact of Treatment

Changes in sexual functioning are common side effects of various forms of bladder cancer treatment. Some of these side effects may include decreased sex drive, erectile dysfunction, problems with arousal and/or orgasm, and pain during sex.¹ Sexual side effects can impact both men and women and may require their own treatment.

Although issues with sexual functioning are common after bladder cancer treatment, not everyone with the condition knows this before treatment. Regardless of knowledge of these side effects prior to treatment, the sexual impact of treatment is not always discussed with a doctor or healthcare provider (HCP) before treatment occurs. We recently conducted our 2018 Bladder Cancer In America survey which polled over 400 adults diagnosed with bladder cancer. One interesting result from the survey was that only 44% of respondents reported that they had a conversation with their HCP about the sexual impact of surgical treatment. 33% had the conversation because their HCP initiated it, and only 11% initiated the conversation themselves.

Tips on communicating with your provider

Talking about sexual functioning may be difficult or uncomfortable for many, which may be why the number of people discussing sexual side effects is low, and even lower for those who were able to initiate the conversation themselves. If you are concerned about the sexual impact of treatment but are unsure how to communicate with your provider, some of these tips may be helpful.

Find a provider you’re comfortable with

If you are not comfortable with your provider, it’s going to be quite challenging to discuss intimate topics with them. If you are currently seeing a provider that doesn’t make you feel valued and safe, it may be a good idea to get a second opinion or try out a different provider, if you’re able. A kind, welcoming provider may make the conversation much easier than expected.

Bring a partner, if you’re able

Not everyone will be comfortable with bringing another person to an appointment where sexual functioning may be discussed. However, if you have a supportive spouse, significant other, or sexual partner, having them there to help facilitate the conversation and be an extra person to bounce questions and ideas off of may be helpful. Your partner may also help calm your fears and help you think of topics to discuss. This will also help keep your partner in the loop on what to expect moving forward.

Do your research and come prepared

Browsing information on reputable websites or from other medically-reviewed resources and having a planned list of questions in mind may help you start the conversation easily, or help you navigate through the topic with your goals and concerns at the forefront. Taking control in this situation may help you feel more comfortable.

Utilize other forms of communication

In some cases, you may not ever feel comfortable talking completely openly and honestly with your provider. If you think you might be someone who will regularly have a hard time opening up about these topics, it may be a good idea to see if your provider uses other forms of communication. Many providers have electronic messaging systems or use e-mail to contact those who come to see them. If your provider participates in something like this, use it to your advantage to send in questions or concerns you have, without being overwhelmed in talking face to face.

Investigating further on your own

Other resources for information on the impact of treatment on sexual function
Even after considering the ideas above, some individuals may still not feel comfortable talking with their providers about this issue. Even if you are comfortable talking with your provider, you may still have additional concerns after your appointment is over and you’ll want to investigate further on your own. Some additional resources for discussing the impact of treatment on sexual functioning include the following:

Join a support group

Joining a group, either in person or online, of individuals who have gone through similar experiences may be helpful in gathering information on what to expect. It may also be easier to ask others who are similar to you what they went through, and get first-hand accounts on how to navigate any sexual impacts post-treatment.

Find a different kind of professional

In some cases, the sexual impact of treatment (or the fear of sexual side effects prior to treatment) may take a toll on mental and emotional health. If you are feeling overwhelmed, scared, or depressed thinking about or managing sexual side effects, it may be a good idea to check in with another healthcare professional, such as a counselor, psychologist, therapist, or other mental health expert to help you best navigate these issues. This kind of professional may also help you come up with strategies for talking with your provider.

Consult reputable sources

Similar to the tip mentioned above on doing your research to guide the conversation with your HCP, you can also do research on your own, and for your own benefit. If you have concerns that you feel too uncomfortable talking with your provider about, but still want to investigate, there are outside resources that may be able to help. However, there is a lot of information on the internet, and not all of it is completely accurate. It’s important to remember that if you’re going to do research on your own, search on sites or within materials that are medically reviewed. Large non-profit organizations, research foundations, medical centers, and government websites are often thoroughly reviewed by a medical professional before any information is posted. These may be good sources to prioritize when looking for information on your own.