Intimate relations post-bone marrow transplant

Oftentimes, I begin writing a blog with an idea of what I want to say, when instead I start typing and something totally different comes out.  Today is one of those days!  I wanted to only give an update on how Todd was doing, but then the issue of intimacy came to mind.

At yesterday's treatment appointment (Day +41), Todd's blood work showed that his platelets went up to 50,000 which is a milestone than many patients and spouses look forward to reaching.  No intimate sexual relations are allowed with platelet counts under 50,000, so this is a positive step in returning back to a normal life.  Cancer can put a real crimp in married life or with any intimate relationship.  Chemotherapy drugs and side effects can be transmitted through intercourse. Many patients have had months of chemotherapy prior to transplant, making this a concern for a long period of time.   I can't speak from a female with cancer's point of view, but according to the Cleveland Clinic's handout on sexuality post-transplant, many women experience vaginal dryness and/or changes in hormones.  (Cleveland Clinic Foundation, 1995-2012).  According to a Danish Study reported by the MDS Beacon, there is also research that suggests that some transplant patients suffer from some type of sexual dysfunction, including increased erectile dysfunction in men. (MDS Beacon, 2011).

While this is a personal subject, it is an issue that must be addressed.  Regardless of any prior birth control measures, condom use is recommended post-bone marrow transplant to prevent transmission of dangerous medication side effects to the spouse, and to prevent even the slightest possibility of a yeast infection. (BMT patients are highly susceptible to any kind of yeast infection anywhere in the body). To make light of the situation, it was funny to be 45 years old, married 23 years, with Todd having had a vasectomy 10 years ago, but still having to buy condoms!

Both the BMT patient and the spouse can have a mixture of fears and feelings when it comes to their intimate relationship.  After recently speaking with another wife of a transplant patient, the lack of sexual intimacy for months can bring feelings of sadness and loneliness.  Being the caretaker, the spouse often feels more like a nurse of a fragile child instead of an intimate spouse.  Kissing alone can be scary for the spouse, for fear of spreading the simplest of germs.  For the transplant patient, stamina, fatigue, and overall energy levels are low to begin with; thoughts of intercourse can be more challenging. Some experience sexual dysfunction or for women, vaginal dryness which can add frustration to the situation.  (MDS Beacon, 2011).  Then, there are self-image issues to deal with.  The loss of hair and/or weight/muscle, can leave the patient feeling less sexually attractive.  

The good news: For most patients and spouses, "This too shall pass."  As blood counts comes up, energy levels come up too.  Once platelets reach 50,000 or greater, sexual intercourse can resume when the patient feels ready for it.  Hair re-growth and weight gain will eventually return to normal adding self-esteem along the way.  There are many medications that doctors can prescribe for dysfunction or hormonal issues.  Patience is key!

For more information:

Cleveland Clinic Foundation (1995-2012). Resuming Sexual Activity after Bone Marrow Transplant.
https://my.clevelandclinic.org/health/treatments_and_procedures/hic_Bone_Marrow_and_Transplantation/hic-resuming-sexual-activity-after-bone-marrow-transplant

MDS Beacon (2011). High Rates of Sexual Dysfunction. Retrieved from: http://www.mdsbeacon.com/news/2011/09/15/high-rates-of-sexual-dysfunction-reported-after-stem-cell-transplantation/