Sexual Health and Life with Cancer

My husband was diagnosed with Stage III Testicular Cancer almost two years ago and underwent four rounds of chemo and an RPLND (among other surgeries like the initial orchiectomy and a lung wedge ressection) over the second half of 2012. 2013 was all about recovering from surgery and he's still in a lot of pain every day accompanied by fatigue, so as to be expected, our sex life looks very different now than it did before all this started (I myself have MS and so am very familiar with the reality of fatigue, but I've been lucky enough to be in remission for the last four years). I'm so incredibly thankful that he's maintaining his remission, especially since his initial diagnosis indicated such advanced disease. He has been so strong and we have built a beautiful life together and he constantly reminds me of how thankful he is that we have each other. I found a note from him on my way to work this morning, "please watch out for wild drivers today while driving in the rain. Get home safe to me. Please. So I can wrap you in my arms and appreciate your genuinely sublime beauty. I love you." 

Our day to day is extremely intimate –– we cuddle and hug and kiss on a daily basis –– but we're both in our late 20s and my sex drive is fairly high (I'd take it every day if that were possible) so I find myself in this constant battle with myself.

We've had penetrative vaginal intercourse once in the last year, occasionally interspersed with mutual masturbation (once every two months or so). These instances are inevitably initiated by me, and he seems much more interested in my pleasure than in his own. He seems to show little to no interest in sexual pleasure for himself. Compound that with the fact that most of the time he isn't up for it anyway, and it is nearly impossible for me to know when he Would potentially be up for it. As a result, I've found myself trying tactic after tactic to initiate sex in hopes that maybe, just maybe, this time he'll be up for it. But that ends up looking like a lot of rejection, and a lot of pressure on him. Neither of these things is healthy or what we want to acheive.

There's the part of me that hears his pain and insecurity, the part of me that tries to reason with myself that we're intimate in so many ways outside of sex, the part of me that feels guilty for even allowing myself to feel this discomfort. But there is this aching reality that my reasonable brain and even my empathetic heart are not enough to hold my lizard brain at bay. Sex matters. And it's causing us both a lot of stress. 

We tried a strategy early on that we would promise to have some sort of sexual encounter once a week, even if it was really minor. But he ended up feeling this enormous pressure leading up to every weekend (which he didn't tell me about until well into the experiment) that pretty much killed it. We try to talk about this stuff together, but I end up feeling really guilty for putting this on him amongst everything else that he has to deal with and I'm left with the feeling like I'm just going to have to suck it up and deal. And now, since mutual masturbation is the standard sexual encounter that we do have, I feel really insecure about even just masturbating on my own in front of him. I would get started and if he was around, he would interpret this action as necessarily wanting to do it with him (which of course would be ideal but I'm happy to take care of myself on my own), and he would gently say, "later". But it's always later later later, so a couple of times I've just gone ahead on my own anyway. But then he feels guilty for not having it in him to participate, which kinda kills it. So I've taken to masturbating in secret. Either in the bath, or in bed in the early morning while he's still asleep. I'll usually tell him about it later and he'll get a little kick out of that, but the fact that I feel I've got to keep it secret in the first place really sucks the joy out of the experience while it's happening. 

It's easy for me to get wrapped up in my own anger and frustration, especially since his pain is invisible to me. He walks around town with me and we go to the gym together and he performs in his band, and I can't help but be screaming inside that Couldn't Some of That Energy Be Spent on Our Sex Life? But there are all of these complicating factors that he sites when we talk about it, including body image issues related to his surgical scars and he's lost so much weight, and even though he still climaxes and feels sexual pleasure, his ejaculations are dry now because of a severed nerve so he just doesn't feel very sexy. I flirt with him and touch him and tell him that he's beautiful and he really is, he's easily one of the most attractive people I've ever met. Everybody says he looks like Gael Garcia Bernal. You must understand my torture! 

His testosterone is in the 200s which is technically in the normal range for a human male, but more typical for a 50-60 year old. Is it normal for Him? His doctors are eager to investigate this, but he seems to be averse to figuring that part out. Is a low testosterone level a threat to his self image such that he would turn a blind eye to the possible truth of it?

The worst part of all this is, the conversation has been dragging on so long that it's now an emotional minefield and I think we're both choosing to avoid it and focus on what IS working. Which works most of the time... except when my lizard brain erupts in torment. 

I know it won't last forever. "The sex will get better when I get better", these are his words. But in the mean time this is really, really, really hard. I feel so alone in this, it's not something that I can really share with anyone that we're close to. Our relationship is strong in so many ways and this journey through cancer has cemented our bond, but I fear that a rift is developing in our sexual health and that this is going to generate real consequences for our relationship and our overall health. Stress is bad for the body, and 2014 is the year for coming back to wellness.