I don't love getting my teeth cleaned. Semiprone in the dental chair, bedecked in a flimsy pink bib, eyeing the tray of shining equipment, I start to feel anxious. Sort of like—and I'm sorry to admit this—the way I feel before sex. My husband and I do still roll in the hay quite often, but the days of a spontaneous pants-off dance-off are behind us. Now we must plan, assembling our own dental tray of sexual accoutrements before getting down to business. Sex has become a production.

The year I turned 50, our youngest child went off to college and I learned I had breast cancer. This diagnosis changed many aspects of our life, not least of which was sex. It seemed a cruel joke that my libido fled with my children—finally, an empty house, and we couldn't take advantage of it. Not only was I facing the changed landscape of my postcancer body—nothing sexier than numbness, baldness, and sleeplessness—but chemo had also plunged me into a swift and dramatic menopause. My moods vacillated between weeping at the tender beauty of a falling leaf and cursing at a sink full of dirty dishes. Day and night, hot flashes swamped me; even my eyeballs felt sweaty. My husband's hand caressing my back was not greeted with generosity. Honestly, I wanted out of my body.

When I was referred to the survivorship counselor at the oncology center, she said slow down, go to bed with no expectations for the earth to move. You may sometimes fail to achieve orgasm, she said. Her language threw me; fail to achieve sounded only like failure. Intimacy is wonderful, don't get me wrong, but it was hard for me to subtract the brass ring of the big O from a session of afternoon delight. She also suggested I be open to new things. Never watched porn? Give it a go. Invest in lingerie, a feather boa, sex toys. My husband and I aren't prudes, but in 25 years of marriage, we'd done exactly none of these things. We couldn't even finish watching Boogie Nights. (Okay, maybe a little prudish.)

Of course, former cancer patients don't have a monopoly on coital disillusionment. How grateful I was when, over coffee one day, my friends, who hadn't had cancer, began to talk about their experiences of middle-aged sex. While they weren't slammed by menopause, the changes were the same: waning desire, increased difficulty reaching orgasm, painful intercourse due to "vaginal atrophy." (According to my friend the nurse, the vagina is a use-it-or-lose-it organ.) Another friend grimly admitted that when she walks, "it feels like two Pringles rubbing together." Her arid nether regions were an apt metaphor: Were we all dried up?

So I set aside my reservations and embarked on a field trip to our neighborhood sex shop. She Bop was as bright and clean as a grocery store. Besides the penis candy necklaces and the BDSM handcuffs, the shop had a huge array of eco-friendly vibrators and paraben-free, vegan, and organic lubricants. (I live in Portland, Oregon.) Also an entire shelf of books on sex after 50, and a section on cancer and sex. I was completely at ease. I paraded out of there feeling like Mary Tyler Moore flinging her tam to the sky.

Though my husband and I don't have a mouth mirror or a perio probe or a flimsy bib, we do now have tools. There's an appliance, lubrication, a glass of wine, a sense of humor. There's also Viagra, because let's be real: Middle-aged men require some propping up, too. Though I don't love the lack of spontaneity, I'm happy to see my husband arranging our dental tray. The thing is, though the cancer and treatment aged me swiftly, and though my body doesn't respond in its old welcome ways when we shake the sheets, I still want the connection of sex. I want to sit across the dinner table from my husband knowing we have an intimate life—that we aren't just roommates or friends. I want to continue to desire and be desired. I want to continue to know his body. And I want to continue to enjoy being in my own.

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