Laura Brashier beat stage 4 cervical cancer, but the grueling treatments killed her sex life. The countless surgeries and radiation destroyed her vaginal tissue and made intercourse impossibly painful.
The Rancho Santa Margarita, Calif., hair stylist was only 37 then, and she found it hard to broach the topic with boyfriends. So she just didn't get involved romantically.
"It was the only thing on my mind," said Brashier, who is twice divorced and has no children. "I dated on and off, but I didn't tell anyone for years. I figured if I am doing that, a lot of others are, too."
Now, more than a decade later at 50, she has created a website for others who cannot have sex because of disease, disability or even disinterest, but want love. The site, 2date4love, launched Aug. 1 and in the first three days it had 2,000 visitors.
"I didn't want to be alone. This was the reason I went online," she said. "My reason is to help a lot of people like me if I can."
Users can write details about themselves and look for others with similar interests without having to worry about the sexual part. One testimonial from a cervical cancer survivor said the site had given her the "hope and courage I've needed to delve back into the dating scene."
Can't Have Sex, But Seeking Love
Those who face physical hurdles in having sexual intercourse are part of a large, silent group, according to Brashier. "Nobody talks about it," she said.
An estimated one in three Americans will have cancer in their lifetimes and aggressive treatments can have an impact on sexual function, according to Dr. Ilana Cass, a gynecological oncologist at Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute in Los Angeles.
"Add in depression and that number is huge," said Cass. "It's a meaningful number of patients and studies are starting to look at the quality of life of cancer survivors, their cognitive function and sexual intimacy issues."
She applauds Brashier's mission and said the medical community is "very much turning a spotlight on these questions."
Brashier learned she had cancer in 1998 after doctors had been monitoring dysplasia, or abnormal cell changes, in the cervix.
"At the time, I had never felt better in my life," she said. "I was not in a relationship, but I was dating and a happy girl."
Doctors performed a hysterectomy, but during surgery, they discovered that the cancer had metastasized. "I was devastated," she said.
Because she was young and healthy, they were able to give her potent chemotherapy and radiation that knocked her off her feet, causing a bowel obstruction and keeping her out of work for eight months. She lost 26 pounds.
"The radiation kind of melts you," she said. "[My vagina] kind of closed up on me and there was so much scar tissue that sex was painful."
Single at the time, Brashier was never able to reconnect sexually. "I was having an attraction with someone at one time, and I was going to tell him, but then realized it wasn't going to happen. Who would sign up for that?"
"I could barely have a conversation with him," she said.
After going online to seek support, Brashier found none. Then two years ago, she contacted a successful friend she had known since she was 13 and he agreed to finance her idea for a website.
"I tried to make it really simple and for a wide range of users," she said.
Brashier hopes her website can cast a wide net to connect those who have had traumatic injuries like paralysis, invasive surgery, extreme radiation and even birth defects. For men, conditions like prostate cancer, high blood pressure and diabetes can also affect their sexual function.
Cancer expert Cass said that it is important to educate patients about how the side effects of treatments can impair sexual function and to give them the tools to preserve their sexuality.
"Intimacy after cancer treatment is an enormous problem," she said.
She said many myths surrounding cancer treatments stigmatize patients and kill the sex drive.
"If you have had chemo, your partner is not exposed by being intimate," said Cass. "Radiation doesn't expose your partner to radiation. Cancer is not sexually transmitted."
Vaginal tissues can scar and younger women can go into premature menopause after chemotherapy and radiation. This can cause hot flashes, loss of libido and vaginal dryness. Hormones and non-hormone therapy can often treat symptoms.
As for radiation, "it's pretty tough on tissues," said Cass. "The vagina is a pretty tough organ, but there can be a certain degree of fibrosis or thickening -- like old leather -- that can be problematic for women."
"We encourage sexual activity after treatment," she said. "If you don't use it, the vagina can close down and stick to itself and become stenotic."
Her advice to female patients is "use it or lose it," and encourages women who have undergone cancer treatment to use a dilator to keep the vagina open. The tissue is incredibly flexible, according to Cass, and can stretch itself back into shape.
Even patients like Brashier, whom Cass did not treat, can experience intimacy without vaginal intercourse.
"There are other ways to express love, including clitoral stimulation, oral sex and other erogenous zones," she said. "You still have some hardware there."
Couples need to be "creative" and to "expand their horizons" to satisfy their need for intimacy, according to Cass. "We are all sexual beings."
As for Brashier, she hopes that 2date4love will help bring intimacy to lonely lives, without the expectation of going all the way.
"It's just the freedom of not having it on my mind when I am talking to a man," she said. "It's really hard for someone else to understand how it weighs on my mind."