Breast cancer: Sex and intimacy

Having a serious illness almost always takes some kind of toll on your sex life: but breast cancer can bring all thoughts of intimacy and sexuality to a very sudden halt.

Treatments can bring on a temporary, and sometimes permanent, premature menopause, making intercourse painful. Chemotherapy and radiation often lead to crushing fatigue. You may want to stay in bed, but you don’t want to use it for anything but sleep. The medications you take, as well as the emotional effects of the disease, can lead to depression. Of course, from the changes wrought by surgery to the hair loss and puffiness of chemotherapy, breast cancer can have a devastating effect on your body image and your ability to feel sexy.

The sexual side effects of breast cancer can linger long after treatment stops. A 2007 follow-up report on young breast cancer survivors, conducted by researchers at the University of California-Berkeley in the US, found that some women reported persistent sexual difficulties five years after their treatment had ended. There are several studies that show between 15% to 64% of women reporting some level of long-term sexual dysfunction.

That’s the bad news: the good news is there is sex after breast cancer!

Sex and self-image

Breast cancer changes the way you see your body. “Women sometimes feel very disconnected from their bodies when they go through this”, says Jean Carter, PhD, a psychologist and sexual health counsellor. “Your body’s been through so much and it’s worked to get well”, she says. “But there have been sacrifices.”

One thing you need to know early on is that your partner still finds you attractive and desirable. That’s rough on the days when you look in the mirror and can’t imagine ever feeling sexy again, much less looking sexy to someone else. It’s important to prepare yourself and your partner for what you’ll see. If you haven’t yet had surgery, ask your breast centre if they have photographs of women after the kind of surgery you’ll undergo. Look at them with your partner and talk about what to expect.

The way your partner looks at your incision for the first time, you’ll remember that forever, says Lillie Shockney, PhD, a specialist breast care nurse. “If he has no clue what to expect and has a puzzled look on his face, the woman may interpret it as, ‘He thinks I’m ugly, he thinks this is awful’.” Showing photographs can take the surprise away.

Communication is important. Talk with your partner about what you’re comfortable with, and what you’re not. “Both partners may be waiting for the other one to make the first move”, says Shockney. “She’s waiting for him to tell her he wants to have sex, and he’s waiting for her to touch him.” Your partner may be afraid of hurting you, or be afraid that you’ll think he’s pushing you to have sex when you’re not ready simply by asking about it.