Whether it be through cancer, childbirth, age, illness, menopause or a kaleidoscope of other issues, the changes that result can heavily impact our confidence, relationships, libido and well being.

Many cancer sufferers get little or no information on the effects that cancer and its treatments will have on sexuality, yet the reality is that after dealing with everything else, sex and intimacy are still vital for the health of our relationships.

Here are just some of the effects that chemotherapy, radiation, surgery and medication have on our bodies:

1. Closing up of the vagina and often a complete 'gluing' together of the internal fibres.

2. Shortening of the vagina - sometimes to only an inch.

3. Severe reduction in or loss of sexual sensation.

4. Dryness, or a lack of lubrication.

5. Loss of libido.

6. Pain during sex (often due to internal scarring).

7. Depression and anxiety.

8. Early onset menopause.

9. Infertility.

10. Radical reduction in confidence, libido and desire.

11. Dramatic reduction in the strength of the pelvic floor, leading to incontinence and prolapse.

Once a survivor has decided to take the step to restore their sexual function, there are a number of pathways to explore. And by the way, things DO get better.

To renew intimacy, build libido and restore fulfilling sexual relations, we recommend the following.

1. LUBRICANTS.

NEVER underestimate the benefits of lubrication. Good quality lubricant is absolutely essential to help your vagina get comfortable, whether for every day use or for sexual activity, particularly penetration. There are three types of lubricant, oil based, water based and silicone based.

We recommend oil based lube such as Viamax Organic Oil Based lubricant to massage into the external skin on the vulva and also internally, as much as is comfortable for everyday use.

Silicone lubricant is essential for sexual penetration if you want to coat the vagina to reduce friction. We can't recommend this product highly enough. Try Pjur Original. It's silky texture never gets sticky and its ability to make sex less painful and more enjoyable is undeniable. It's also excellent for massage on skin that is fragile and sensitive.

Water based lubricant is perfect to use with silicone dilators and vibrators and can be wonderful as an internal moisturiser. Sliquid Sassy and Satin are one of the highest quality brands in the world. If you need to get the lubricant up higher into the vaginal canal, we recommend the Yes brand of lubricant that comes with an applicator.

2. MASSAGE AND SELF LOVE

After cancer, there is a lot of grief, anger and loss to work through. Massage is a wonderful way to heal the body and gently work through physical as well as psychological trauma. Massage candles can be extinguished and poured directly on the skin for deep relaxation and delight (but don't use them internally). Good quality massage oil is great to have on hand to use as part of foreplay and lovemaking.

SOLO PRACTICE - Set aside an hour a week for your sexual self. Set up a supportive space with no distractions, burn your favourite oils and stretch your body. Learn meditation and calm your mind. Start a pelvic floor strengthening routine. If you need to increase your libido, use this time to read erotica and introduce sex toys. Treat yourself to a massage, either before your practice or afterwards.

COUPLES PRACTICE - both partners need nurturing, love, support and healing. Learning to massage well gives so much and opens the heart. Opening the heart is the first step toward renewing intimacy, regaining trust and acceptance of what has been lost. Sexual, erotic massage can open new pathways within body and mind, revitalize deadened nerves and heal a myriad of ills. Read books, practice regularly in a relaxed environment and use a good quality, body safe lubricant as an internal massage oil.

 3. TANTRA

Tantra is the practice of mindfulness and employs exercises that can elevate the experience of sex to a higher level. Tantra is about the journey of sex, not the destination and it is with this understanding that its use is invaluable. Using tantra can help couples enjoy sensuality when orgasm is not physically possible in the sense that we traditionally understand it. There are many wonderful books and practitioners that can help couples achieve extraordinary results. Tantra is not a quick fix, but a practice similar to yoga, that takes dedication and discipline.

4. SEX TOYS

Small vibrators can be used to help dilate the vagina and increase pleasure and sensation. Air Pressure toys engorge the clitoris, helping with blood flow and restoring feeling (as well as providing fantastic sensations). Silicone dilators help to bring elasticity back to the vagina and can be pleasurable too. Vibrators that can be used both externally or internally when ready. We love these slender, super soft and cute versions. There is a sex toy to suit every person and situation and all you need is a willingness to experiment with different varieties. Internal balls are also an excellent way to restore strength and elasticity into the vagina.

5. ADVENTURE

Bondage and S&M can be very erotic and can ignite many fantasies and roleplays. Blindfolding and tying up are a way to heighten awareness of the body by shutting off other senses. Reading erotic literature, watching porn, dressing up, inventing scenarios and planning romantic dates are all ways to build anticipation and keep sex at the forefront of your mind.

5. LINGERIE

Whether it's pretty, sexy, innocent, trashy or classic, dressing for the bedroom is great fun and can hide scars as well as giving confidence. Thigh high stockings with high heels can work wonders!

6. THERAPY

If you feel you need more support, whether it be as an individual or a couple, seek out further help. In Melbourne we have a great sexologist and counselor, Chantelle Otten, who specialises in sexuality post cancer.

A fulfilling sexual life is not always restored on its own, and for most of us, it takes time, patience, strong communication and commitment. Sometimes it's easier to think that sex is not that important in the scheme of things but sexuality strengthens our connection with our innermost self as well as our partners.

If you are in a relationship, sex, intimacy and trust nourish, heal and ameliorate the trauma. If you're single, building your sexual energy revitalizes your entire body and helps to complete the process of making you whole again. Self pleasure will help  you understand your body and allow you to communicate your needs and desires to future partners.

Orgasm is brilliant for your vaginal health (not to mention your psyche) and you should feel encouraged to take charge of your pleasure. We are here to talk to you and help you through any issues you're having and we love recommending amazing products specific to your personal needs.

Drop in any time to speak with our well trained staff or grab some of your survivor friends and enjoy a private session in the store.

At Passionfruit, we are available to speak at events and have held workshops for BCNA support groups. We offer training in sexual products for professional support and medical groups. Contact Michelle at michelle@passonfruitshop.com.au for more information.

All Images by David Jay Photograpy