Lindsey: This is Sexplanations, brought to you by OHNUT, the first wearable that customizes penetration depth for anyone who experiences discomfort when penetration is too deep for their liking. It helps partners enjoy their bodies and each other.

[intro]

Hi, my name is Dr. Linsey Doe, I'm a clinical sexologist and doctor of human sexuality. This is Sexplanations.

Half of us are projected to have cancer at some point in our lifetimes, and the other half will likely know and care about many people with cancer. Let's talk about how this affects sexuality. I asked a friend in oncology - the field of cancer - and he said some radiation can lead to temporary or permanent impotence - not being able to get erect. Chemo can cause infertility, diarrhea, nausea. Hormone therapies can launch a person into early menopause. There's vaginal dryness, loss of sensation, taste changes, pain, discomfort, time needed to heal from surgeries, bleeding, fatigue, weight gain, weight loss, incredible alterations to body image, scars, amputations, moon face - where the cheeks get puffy, hair loss.

Partners don't always know what to do. Can they even touch the person? Is sex an option anymore? In short, he said there are tons of reasons people have difficulty with sex. [slide] "A 2009 study by Hawkins and colleagues found 76% of respondents reported 'cancer negatively impacted their sex lives.' When the cancer involved reproductive sites like the breast, testicles, and cervix the number was even higher at 84%." 59% of women and 79% of men said that sex and intimacy decreased or stopped altogether. Even though some of them desire to feel sexy, touch, connect, date, and have sex. So, what are the solutions?

First, identify your people. At least two people who will advocate for your sexual well-being: your friend and your nurse, your partner and your therapist - two of them. Two others who agree a cancer diagnosis doesn't mean choosing between being alive and being sexual. I put a link to a contact directory for some of your people in the description.

Next, have the sex talk. Start an ongoing conversation about cancer and sexuality. If you're the one with cancer, a survivor, the partner - talk. Ask questions: "What do we want sex to look like? How will this treatment affect sexual functioning? How long will the changes last?" Doctors and other healthcare providers admit that they overlook sexuality and palliative care - medical care for serious illnesses. Which puts the responsibility on the patient to bring sex up.

In the words of Dr. Stacy Tesler Lindau, "[Doctors] don't raise this topic, we're not sure what to do about it, it takes time to address it. Some doctors, we bring our own hang-ups to the practice of medicine... The more doctors are asked the better we'll get at answering questions."

It's not idea, but you're curious and capable. Here are some questions to ask: "Who specializes in nerve-sparing surgery? Is this possible?" As more healthcare professionals incorporate sexuality into their treatment plans, we see more surgical techniques to keep nerves near the tumor intact, which means that it may be possible to undergo a mastectomy and keep your nipple or remove prostate cancer without erectile difficulties. The question is which surgeons can remove cancer without harming organs that enhance sex.

"Can you write me a prescription for lube and dilators?" Some cancer treatments cause vaginal dryness, tightening, and shortening. Applying K-Y Silk-E or Replense to the vulva and vagina and using dilators two to five times a week helps counteract this. Dildoes are also an option, and penises, and/or fingers. Good 'ol penetrative sex three times a week can prevent scarring and adhesion so that the vagina doesn't seal up. Ah! The benefits of sex!

"What's my platelet count?" Chemotherapy - a drug treatment designed to kill cancer cells - weakens the immune system, which means if you have fewer than 50,000 platelets per microliter of blood, you'll likely be discouraged from intercourse. Having more than 50,000 platelets doesn't necessarily mean sex is a good idea or that you'll even want it, but it's a starting point. Note - if you do hook up on chemo, the chemicals aggressively killing cancer in one person can be passed to the other person via saliva, vaginal fluid, and semen for up to 72 hours after IV and oral treatments.

Let's ge creative! Your body will change, all bodies change. With cancer, many people lose their hair - alopecia. That's your head, your pubes, your eyebrows - all of it. How do you want to cope with this? YouTube makeup tutorials for eyebrows, wigs, hats, henna, scrolling through sexy bald role-models. Can you treat yourself to some outfits that accentuate parts of your body you like while also being super comfy? Black fishnet stockings? Grey sweatpants? Cotton bondage ropes? A superhero cape? Hannah Witten has lingerie recommendations for ostomy bags linked in the description.

Some procedures like hysterectomies that remove the uterus and cystectomies removing the bladder also remove 1/3 to half of the vagina. If the vagina is an average of 3-5 inches at a resting state, this is a dramatic change in depth. Getting creative here can mean new sex positions, like closing your legs to mimic more length. Using OHNUTS or similar products to create a skin-like extension out from the orifice - the vagina, anus, mouth. Or there's focusing more on oral sex, more anal.

Most people recovering from prostate cancer will not be able to have erections or completely control urination temporarily or permanently. Some of the creative ideas being used by malecare.com include cock rings, vacuum pumps, and learning to dry orgasm - come without ejaculating. One of you recommended from personal experience studying breath energy orgasms - or "thinking off" - which uses tantric techniques to come without physical stimulation. I would add hollow strap-ons you can put your penis into and still thrust with. Investing time and skills like manual and oral play, leaning into golden showers, moving orgasmic sensations from the genitals to another part of the body like the wrist or the neck. And expanding the meaning of sex.

Maybe sex becomes watching porn and dry humping, BDSM, making out and interlocking fingers, feeding each other grapes and sharing fantasies. "If I had all my strength right now I would [self-censors] and [self-censors] you for hours." Right? Hot! Y

our care team will probably explain that side-effects of cancer and cancer treatments are messy. What if you had and overnight bag just like you would for sleepovers that is stuffed with feel-good items to make you feel less sick and more sensual? Create a love-packed shag bag! And in it you could put together ginger chews and queasy drops for nausea, a tiny bottle of mouthwash, baby wipes, chapstick, snacks, condoms, hand-warmers, lube, a cock ring and a vibrator, hand lotion, cozy socks, water bottle or thermos for peppermint tea, and headphones to rock out to your favorite sex songs.

The last solution I have for the sex/cancer dilemma is to grieve. Be pissed. Sullen, depressed, blame others, blame yourself, bargain with Aphrodite and the grim reaper. Deny that this is going to affect your relationships, finances, ambitions, physique, and libido. If you're going to make it through the physical agony of cancer, you're going to need your mind, and that generally means working through grief. Probably. Here are some gnarly grenades to watch out for as you process:

The thought that you destroyed your sex life to please a doctor or get a few extra weeks of life. The thought that you're not a worthwhile lover anymore because you're so lethargic. Get it, have lazy sex, I love it.

For people who have gender-transitioned, cancer can be incredibly triggering, bringing up dysphoria with your anatomy, having to stop hormones that are gender-affirming. If cancer is a result of the sexually transmitted infection HPV, this can be an enormous barrier to wanting more sex - sex gave you cancer in the first place: "Dating is already challenging. How am I going to find someone who's okay with my problems? I'm gonna be alone!" We all have variations of these worries: anger with injustices of life, fear of uncertainty - but cancer is an additional butt-head.

Sexologist Dr. Beverly Whipple found the pain threshold increases by 75% for some people during orgasm. Take that, cancer! I put a list of all the awesome resources in the description as well as a playlist of videos I think are pertinent. This isn't a comprehensive lesson on sex and cancer; we're all so different and so are treatment plans, but it is my hope that this inspires you to stay curious.

Quick sexplanation of OHNUT - these super-soft, flexible rings are meant to be worn on the penis, dildo, peen, etc. as a buffer between bodies which feels shockingly natural for all parties. You slide it over the phallus and the OHNUT limits depth without limiting pleasure! It's an absolutely brilliant way to customize penetration; great if you experience any of these conditions, including cancer, and want to have all of the feel-goods without the stress of a hard object ramming up against the end of your orifice. One package includes four stack-able OHNUTS. OHNUTS, like "donuts." I've put a link in the description to use discount code "sexplanations" for 10% off at ohnut.co.

A big thank you to everyone who helped me make this video: oncology teams, cancer survivors, those of you with questions, patreon sexpla(i)nauts, and the production crew.

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Ee-ha!