Maintaining a Healthy Psychosocial & Psychosexual Lifestyle at "Thriving thr Breast Cancer" organised by Breast Cancer Welfare Association Malaysia in Kuala Lumpur on Sat 13 August 2016. Dr Martha Tara Lee is Founder and Clinical Sexologist of Eros Coaching since 2009. She is a certified sexologist with ACS (American College of Sexologists), as well as a certified sexuality educator with AASECT (American Association of Sexuality Educators, Counselors, and Therapists). Martha holds a Doctorate in Human Sexuality as well as Certificates in Sex Therapy, Practical Counselling and Life Coaching. She was recognised as one of ‘Top 50 Inspiring Women under 40′ by Her World Singapore in July 2010 and ‘Top 100 Inspiring Women by CozyCot Singapore in March 2011. Website: http://www.eroscoaching.com.

1. PRESENTATION NAME
Maintaining a Healthy Psychosocial
and Psychosexual Lifestyle
@ Thriving thru Breast Cancer
Breast Cancer Welfare Association Malaysia
Sat 13th Aug 2016

2. Dr. Martha Tara Lee
Clinical Sexologist
• Doctorate in Human
Sexuality
• Masters in Public Policy and
Management
• Bachelor of Arts (Comm)
• Certificate in Sex Therapy
• Certitificate in Practical
Counselling
• Cert in Life Coaching

3. Agenda
1. Sex + Surgery Myths
2. Dealing with Sexual
Desire + Arousal
Problems
3. Sexual Tips
4. Single women with
breast cancer
5. Conclusion

4. Sex Myths
1. Sex is a sensitive topic.
2. Sex is only for making babies.
3. There is a cut-off age for sex
4. He knows what he is doing.
5. There is a “best” way to have sex
6. More sex is better.
7. Faster is better.
8. Sex is incomplete without the orgasm.
9. Need desire for sex.
10.Need emotional connection for sex to happen.

5. Misconceptions about Sex and
Intimacy After Surgery
1. Be grateful to be alive.
2. Things will get better.
3. Sex is about
penetration.
4. Sex is about the
orgasm.
5. Sex is all about him.
6. No need to think about
sex if single.
7. Too old anyway

6. Issues of intimate sexual
relations at advancing age
A woman may notice
changes in her vagina. Her
vagina shortens and narrows.
The walls become thinner
and also a little stiffer.
As men get older, erectile
difficulties becomes more
common.

7. Dealing with Sexual Desire and
Arousal Problems
Problem Side Effects Treatment
Arthritis Joint pain due to arthritis can make
sexual contact uncomfortable
• Exercise, rest, warm baths, and
changing the position or timing of
sexual activity
• Joint replacement surgery and
drugs may relieve this pain.
Chronic
pain
Can lead to sleep problems,
depression, isolation, and difficulty
moving around.
Chronic pain can often be treated.
Diabetes Many men with diabetes do not have
sexual problems, but this is one of the
few illnesses that can cause
impotence.
In most cases medical treatment can
help.

8. Problem Side Effects Treatment
Heart
disease
Narrowing and hardening of the
arteries.
Can lead to trouble with erections in
men, and high blood pressure
(hypertension).
Always follow your doctor's advice.
Incontinence Loss of bladder control or leaking of
urine.
The good news is that this can
usually be treated.
Stroke Problems with erections are possible Try using different positions or
medical devices to help them
continue having sex.
Dealing with Sexual Desire and
Arousal Problems

9. • Sickness or feeling sick
• Tiredness (fatigue)
• Irritability
• Sadness or depression
• Frustration, anxiety or tension
• Pain
• Bowel problems such as diarrhea
• Breathing, Mouth and Bladder
problems
• Skin changes or scarring
• Changes in your sex hormones
• Concerns about changes in the way
you look
Having Cancer or its Treatment can
Cause

10. • Difficulty with self-esteem
because of feeling ill and being
unable to fill all your usual roles
in the family and at work
• Body image changes from
surgical scars or openings that
affect how you feel about your
body
• Affected by what your partner
may experience.
• Stress in the relationship with
your partner
Emotional Effects of Treatment on
Sexual Functioning

11. Sexual Functioning Concerns and
How to Find Help
Loss of desire for sex after cancer
• Check your medications for possible side
effects.
• Get medical treatment for pain during sex
that will not go away or fatigue.
• If you are in menopause, see a gynecologist
or an endocrinologist.
• If there are no physical causes, see a
licensed mental health professional to find
out if your loss of desire could be related to
feelings of depression,
anxiety, low self-esteem,
or relationship conflict.

12. Sexual Functioning Concerns and
How to Find Help
Negative thoughts and feelings during sex
• Women often find themselves
distracted during sex by
negative images and thoughts
• Try focusing on pleasurable
feelings in your body or on a
sexy thought or fantasy.
• Support from mental health
professional who can help you
change negative feeling and
thinking patterns

13. Sexual Functioning Concerns and
How to Find Help
Vaginal dryness and tightness, making sexual
activity uncomfortable or painful
• Talk with a gynecologist
• Over-the-counter vaginal
moisturizers for before and during
sexual activity.
• You also may benefit from learning
to control the muscles around the
vaginal entrance.
• Some women can benefit from low-
dose vaginal estrogen in a cream,
tablet or ring form.

14. Vaginal Renewal
1. Moisturizing the
skin of vulva and
vagina
2. Massaging your
vulva
3. Internal massage

15. Sexual Functioning Concerns and
How to Find Help
Difficulty feeling pleasure during sex
• If you have lost feeling in an
area of your body that gave
sexual pleasure you may need
to find new caresses that you
enjoy.
• Communicate with your partner.
• Ask for a referral to a sex
therapist who specializes in
treating cancer survivors.

16. Sexual Functioning Concerns and
How to Find Help
Difficulty reaching orgasm
• Ask your health care team to check your
medications. Antidepressants or anti-
anxiety medicines may make it more
difficult for you to have an orgasm.
• Give yourself time. Try not to pressure
yourself to have an orgasm. Try to have a
goal of enjoying sex and getting as much
pleasure as possible. The nerves that
help a woman feel pleasure around the
clitoris and in the vagina are rarely
damaged by cancer treatment.

17. Kegel Exercise
•Frequency
•Duration
•Intensity

18. Sensate Focus
Stage 1
•Without genital touch
Stage 2
•With genital touch
Stage 3
•Go with the flow

19. • Enjoying being close
to each other
• Touching and stroking
• Kissing
• Massaging
• Talking
• Holding hands
Focus on Showing your Feelings for
One Another in Other Ways by

20. Communication
• Code Words
• Red, Yellow, Green
• Open Ended Questions
• Closed Ended Questions
• Scale 1 to 10

21. Why Do Medical and Mental Health
Care Professionals Need to
Understand Sexual Problems?
Sexual problems have
an adverse effect on
interpersonal relationships
and the quality of life.
Copyright 2012 Eros Coaching

22. Single Women with Breast Cancer - if
Dating and want a Serious Relationship
• Find a friend
• Practice
• Be honest
• Put yourself in a
potential partner's
place
• Move on

23. 1. Sex Is Bigger Than Any
Body Part
2. Even If You’re Afraid To
Ask — Ask
3. Don’t Wait, Act Now
4. You Are Not Alone
5. Don’t Give Up
Takeaways

24. Thank you!
Martha Lee
Clinical Sexologist
Eros Coaching Pte Ltd
Website: www.eroscoaching.com
Email: drmarthalee@eroscoaching.com