Renewing intimacyFor some patients diagnosed with myeloproliferative neoplasms (MPNs), going through the stages of illness, diagnosis, treatment and lifestyle adaptation, intimacy can slip off the radar. A psychologist from the US Mayo clinic offers these tips for renewing intimacy. It can be very difficult to raise concerns with your haematologist or GP about how illness affects your sexuality. What’s more, even seasoned medical professionals can feel uncomfortable responding. But people with medical conditions need answers. Dr Jan Swanson PsyD, LP, a doctor of psychology and a licensed psychoanalyst, offers advice and support to patients with MPNs and other disorders in her work at the Mayo Clinic (US). She offers these tips: People need touch The foundation for sensual and later sexual pleasure begins in the arms of those who first loved and cared for us, our mothers, fathers, grandparents, nurses. Later in adolescence, sexual hormones trigger our interest in sexual pleasure and promote our first experiences. We enter into the first half of adult sexual lives when reproductive hormones strongly influence our interests and behaviour Shifts occur in midlife Very subtle changes begin to occur in the second half of life; intimacy gradually becomes more about pleasure, less driven by hormones. But events such as illness can lead to more abrupt changes in our sexuality. Illness can cause changes Stress, pain, fatigue, anaemia and medications can reduce sexual drive. Chronic illness can affect sexual performance, decreasing libido, slowing arousal or causing discomfort and pain. Illness also affects relationships by damaging self-image, lowering esteem and leading to discrepancies between needs and performance. We want to develop new awareness “We begin to see our bodies differently as we experience physical changes. We need to reconnect with our bodies, to look with new eyes,” explains Dr Swanson. Forming an intention We can consciously cultivate the pleasure of touch; we can invite pleasure into our bodies. We want to become more aware of the state of our hearts, minds and bodies, and form an intention to bring the sensual side of our beings to the forefront. Communicating effectively “If you have the courage to bring up issues of intimacy, if you take the initiative, this frees up your partner and opens a dialogue”, explains Dr Swanson. How you express yourself matters as well. “We often communicate when we feel dissatisfied”, says Dr Swanson, but we can also voice encouraging and reassuring messages. Developing resilience Dr Swanson often sees patients and their partners holding hands or gently touching a shoulder: small gestures of caring. “Intimacy can last for a lifetime, into our seventies, eighties and beyond. It’s wonderful to see the resilience of these couples”, she says. In all aspects of dealing with the challenges of living with MPNs, we would encourage you not to bottle up feelings and disappointments so do look to talk with trusted friends or a counsellor and ask your GP for help.