Читать книгу The Lovin' Ain't Over for Women with Cancer - Ralph Alterowitz - Страница 7

During our numerous individual and group interviews, many women indicated their lack of knowledge concerning the woman’s sexual response cycle. They did not know what was happening or should happen during a sexual encounter.

In talking about sexual problems, many women said that they missed having any desire for sex since their chemotherapy. A number of women also said that they had never had an orgasm, or were not sure whether they had ever had an orgasm. And now they fear that the cancer treatment will prevent them from ever having one. They are concerned and anxious about having cancer, and the fear of adverse consequences relative to their sexuality makes them even more apprehensive.

Ever since the work of Masters and Johnson, researchers have talked about sexual activity as consisting of four sequential phases. Desire, arousal, orgasm, and satisfaction (sometimes called resolution) are considered to constitute the female sexual response cycle.

Many women worry that when they do not feel sexual desire, they will not be a good sexual partner and will not experience personal pleasure. They believe that desire is the window to having and enjoying sex. However, in 2000, Dr. Rosemary Basson showed that arousal can come before desire or afterwards. In other words, arousal can prompt desire.

Results of studies show that for many women, the genitalia respond to sexual stimuli, even though their minds seem to be “stuck in neutral.” This explains why a woman with cancer may feel no desire, yet her body is responding.

It may alleviate some women’s anxiety on this issue to know that the mind and the body can play different tunes where sexuality is concerned. Good loving takes time, because the woman needs to be brought to a point of sexual receptivity and arousal. As a woman gets older, or experiences sexual effects of cancer treatment, she may need more foreplay to come to a point where she desires sex and is aroused. Many of the physiological effects of arousal, such as feeling warm and sensing some stirring in the genitals, are the same sensations a woman has during desire.

As she goes through the normal sexual cycle, a woman experiences physical changes in her breasts and genitals. During the arousal phase, and sometimes when she feels desire, her nipples are likely to swell, and she may feel some wetness and enlargement of the vagina, preparing her for intercourse. Her heart rate increases because more blood is pumping to certain areas of her body, especially her pelvic area. She may feel flushed as more blood is pumping to her face.

During the height of the arousal phase and before orgasm, a woman reaches a plateau. According to Masters and Johnson, the feelings that occur during excitement and arousal reach their peak in the plateau phase. The woman feels more sensitivity in her genital area. Her heart rate increases and the clitoris becomes engorged, ready for further stimulation so that she can reach orgasm.

Orgasm is the culmination of excitement. At this time, the woman often experiences contractions of the muscles in the pelvic area, especially the vaginal and rectal sphincter areas. Her muscles go into a recurring series of contractions, sometimes leading to a spasm in other muscles in her body.

The last phase, now named satisfaction, is the release. This is complete relaxation, where the heart rate, breathing rate, and muscle tension all gradually return to normal.

Not all women experience all the phases or all of the sensations in any of the phases. In addition, chemotherapy, surgery, and radiation can each change the way a woman’s body responds. For example, many women who have gone through chemotherapy get upset when they realize they have little or no sense of sexual desire. This is sometimes a temporary condition, but it may be long lasting.

Because desire can come before arousal or arousal can come before desire, if a woman does not have any desire, she might still be able to respond to her partner initiating love-making. Since research shows that female desire is driven by emotional attachment, her partner’s advances could “turn her on” sexually.

Desire is partly emotional and partly physical. Feeling desired is a strong component of the emotion. Thirty or forty years ago, researchers and others such as sexuality therapists believed that a woman’s sexuality was independent of what went on outside of her. However, subsequent research shows that a woman is strongly responsive to her partner’s feelings for her. Even if she already feels desire, her level of arousal increases if she feels wanted by her partner.

People undergoing treatment for cancer have experienced the change Dr. Basson presented in her research. Many people, both men and women, who go through various therapies become aware that they have little or no sexual desire. However, after the partner begins caressing, kissing, and touching, they can become aroused. The keys to arousal and then the desire to continue the sexual activity are receptivity to the partner’s actions, sensitivity, and emotional responsiveness.