Fatigue is intimately related to sexual function and desire. Many of the problems that cause fatigue, such as low estrogen or testosterone levels, also impair libido and sexual function. Keep your doctor aware of any change in sexual function, because it will help him or her determine the cause and appropriate treatment for your
fatigue as well as your diminished sexual function and desire.
Grief, so common during recovery, is a physiological as well as psychological process that can cause both decreased libido and listlessness. As you grieve your losses, you may have no interest in sex for a while. However, if this lack of interest persists, consult with your doctor because physical or emotional issues other than grief may be responsible for it.
On a practical level, if your daily activities sap every last ounce of your energy, none is left for sex. In addition, the ongoing stress of dealing with the limitations imposed by your low energy can lead to chemical or hormonal changes in your body that manifest themselves as diminished sexual function. These changes can occur despite a positive attitude, emotional stability, and optimal social circumstances.
However, human sexuality is a highly complex phenomenon. Since sexual interest and function are influenced by your environment and emotional state, fatigue may indirectly inhibit them. For example, relationships strained by your lack of enough energy to perform (housework, child care, or job) are less conducive to sexual enjoyment.
Anxiety, low self-esteem, and fear about your changed body sometimes, subconsciously, may lead you to avoid sexual activity through crippling fatigue. Recognizing when this is a contributing factor will help you deal with the real issue: adjusting to your changed body image. Resolution of this problem will encourage a return to normal sexual activity.
While you were being treated for cancer, significant limitations may have prevented sexual activity. Hospitalization, severe pain, intractable nausea, and treatment-induced lethargy prevent sexual relations no matter how strong the desire. These limitations, lifted during remission, can leave their mark: you and your partner are less spontaneous and comfortable in relating sexually. Prolonged abstinence or near-abstinence may cause you to get out of the habit.
If during your treatment phase you had pain that was exacerbated by sexual activity, initiating sex or even thinking about it may trigger a conditioned type of anxiety or inability to function, even though the pain is now gone completely. This complaint usually responds to appropriate treatment. It is similar to a woman’s meeting her chemotherapy nurse in a grocery store ten years after the end of treatment and immediately getting nauseated and throwing up. (Needless to say, the encounter doesn’t make the nurse feel very good, either.)
Fatigue and diminished sexual function are often interrelated. Attention to both will facilitate their improvement.