Anita Paulsen is a nurse and sexologist. She recently defended her doctoral degree on sexual health communication after gynecological cancer. Through her work and research, she has met many cancer survivors who miss the intimacy in their lives.
"One couple I met made an impression. They had stopped being sexually active but had also stopped kissing and hugging. And she missed it very much. She longed for what had been. There was so much sorrow there," says Paulsen.
The topic of sexual life after gynecological cancer is often not discussed, neither by patients nor health professionals. This is something Paulsen has researched.
Read her entire thesis by following this link
Not talked about
"Many find it difficult to talk about this, even women who say they are in good relationships. Sex and finances, some relationship therapists say, can be difficult topics," Paulsen says.
Sexuality is a topic that is easy to overlook. Cancer patients receive treatment for tumours – but they are not routinely asked how treatment affects their desire, intimacy or their sense of self as women. Many women experience that sexuality not only disappears from life – but also from conversations.
Health professionals often shy away from the topic. Not because it is unimportant, but because it is difficult.
"Patients think that since the nurse doesn't bring it up, it can't possibly be important. And nurses think 'I should have asked, but I'm so busy and I don't quite know what to say.' So, no one says anything," says Paulsen.
The result is a double taboo. Both the patient and the health professional wait for the other to open the door to conversation.
Simple words make a big impact
Paulsen interviewed 17 women who survived gynecological cancer and 10 nurses who worked with cancer patients.
Her doctoral work is part of the LETSGO study, which you can learn more about by following this link.
In her doctoral thesis, Paulsen examined a new model in which nurses routinely bring up sexuality in follow-up conversations with cancer survivors. Many of the women said that just being seen and heard made a big difference.
"It may be enough for someone to say: 'You're very tired now. It's normal not to want sex, and that's perfectly okay.' This can have a big impact on many."
The nurses in the study did not have specialist education in sexology but received training in how sexuality can be affected after treatment for gynecological cancer and how to communicate by asking open and respectful questions. They could also refer on if necessary.
Not like before
Some of the women said they had a new and better sex life after cancer treatment.
"They described finding greater peace in their sex lives and a more relaxed approach to it. They needed more time to get into position in the sexual situation, which their partners understood," says Paulsen.
Others described sadness about what had happened to their bodies and desire, and about who they used to be.
Paulsen believes sexuality must be understood more broadly than just as a function.
"It's about identity, body, intimacy and joy in life. Also after cancer," says Paulsen.