For most women, our breasts, bodies, and sensuality are topics that we’ve received many mixed messages on throughout our lives. Add in the physical and emotional changes that a breast cancer diagnosis and treatment bring, and it’s no wonder that returning to physical intimacy with a partner is a steep challenge. Emotions about the loss of your breast(s), insecurities about appearance, physical changes resulting from surgery, or hormonal changes like lower libido and vaginal dryness, all contribute to changes in how women may view their sensuality after diagnosis.
Sexuality-related issues tend to be underestimated in clinical practice, and the impairment of sexual function can negatively influence the QOL of these women (Tozatti et at, 2021).
According to a 2020 study by Mattei et al., titled “The Long-Term Effects of Cancer Treatment on Sexuality and Couple Relationships,” 75% of patients qualified for sexual dysfunction as measured by the FSFI (Female Sexual Function Index) global scale, and 71.9% declared they were not adequately informed about the side effects of treatments on sexuality. The high prevalence of sexual dysfunction [in those diagnosed with breast cancer] underlines the need for specific attention being paid to this problem, starting with a complete and targeted communication between patients and health providers regarding these side effects.”
Physical intimacy is an important part of many relationships. We recognize that intimacy and sexuality encompass so much more than just sex. You can connect to these aspects of yourself and your relationship through other forms of physical intimacy (kissing, cuddling, massage, etc.) and emotionally, but I do not believe our breast cancer community is going to settle. We are grateful to be alive, yes, and we want quality of life. Read on for more on how to reconnect with your sensuality, and how your partner and healthcare team can help you as well.
“If your sex life is not working the way you want it to, your doctor or nurse may be able to referee these issues with your partner and you. You can cue your doctor in advance, since he or she has most likely already touched on delicate issues with you. Maybe he or she can be the tour guide for the two of you. If your partner is there when you talk with the doctor who's managing your care, you and your partner both get a chance to air and dispel fears, and replace myths and false information with facts.
Not all doctors and nurses are comfortable discussing sexual issues and practices. Most doctors don't routinely ask about your sex life. And patients don't usually begin to discuss their love life with a doctor who hasn't mentioned it. Nobody's talking! Read More.
From Around The Web
“Can I have sex during treatment? There are a few factors that determine if sexual activity is safe during treatment:
In general, sexual activity is fine during treatment as interest, energy, and comfort levels allow. Women may not feel up to sexual intimacy after surgeries or during chemo and radiation. Hugging, holding hands, and massages may feel good and be comforting.
If you have a low white blood cell count or low platelet count (concern arises with platelets below 50,000), you will need to refrain from vaginal, anal, or oral sex. This is because there is an increased risk of infection or bleeding when your counts are low.
If you have mouth sores (mucositis), you should not perform oral sex.
Do not have vaginal intercourse if you have open sores on the genitals or in the vagina.
There are certain chemotherapies that caution you about becoming pregnant while on treatment and for a specific amount of time after treatment is done. See the package insert for your chemotherapy or ask your pharmacist for this information.” Read More.
“After breast cancer treatment, women often have complex emotions about visible scars, loss of sensation, or losing your breasts or nipples. ‘Learning some self-compassion is important,’ said Jennifer Barsky Reese, PhD, a psychologist and behavioral scientist at Fox Chase Cancer Center who studies breast cancer and sexuality. ‘It may take a while to become adjusted to those changes. These types of concerns are very common, and for many women they may improve over time. If you’re having significant trouble adjusting, it could be useful to visit with someone about those concerns. For instance, if you notice yourself avoiding looking at your body, looking at your body too much or in a judgmental way, or if your body image is interfering with your sex life, mood, or relationships, these may be signs that it could be helpful to deal with these issues head-on.’ Talk to a health care provider who you feel comfortable discussing these kinds of topics with. Counselors or sex therapists could also be helpful, depending on your needs. ... Some women with breast cancer are treated with chemotherapy or hormonal therapies that may cause symptoms of menopause, such as vaginal dryness or tightness. Over-the-counter products such as vaginal lubricants for use with sexual activity and vaginal moisturizers that are used regularly whether or not sexual activity is happening can help with vaginal dryness, and these are available at your nearest pharmacy.” Read More.
“Tips for getting back to sex:
Start afresh: Try not to compare things now to how they were before you were diagnosed with breast cancer. It can take time and patience to adapt to the changes resulting from breast cancer.
Explore your body: It can be useful to explore your body on your own first. You may wish to use your fingers or a vibrator. You may find using a vaginal lubricant helpful. This can help you discover what kind of touch is still pleasant or where it is painful.
Don’t rush: Taking things slowly at first may help. Think about what kind of level of intimacy you feel comfortable with and how much energy you have. There may be practical things to consider, such as taking pain relief if necessary.
Wear what makes you comfortable: Some women may feel uncomfortable naked and choose to wear nightwear. Others wear a prosthesis and bra to bed. It’s important to do whatever makes you feel more comfortable and relaxed, even if this makes intimacy or sex less spontaneous.
How you feel about having your breasts touched after treatment is very personal. You may want your partner to touch the area that was treated, or you may not want any touching at all. Some women don’t want their partner to touch the breast that wasn’t treated if it reminds them of the loss of the other one. Your partner may also feel differently about touching your breasts after treatment. It may be helpful to tell your partner what sort of touching you want or don’t want. If you find talking about it embarrassing, you could use your hand to guide them. How you feel about having your breasts touched may change over time.” Read More.
Overcoming physical and emotional roadblocks to intimacy after breast cancer (Cancer Treatment Centers of America)
Traci Owen, RN, BSN, CSC, SE, Oncology Sexual Health Specialist at Cancer Treatment Centers of America (CTCA), Tulsa shares some of the common concerns and challenges that women experience around intimacy after breast cancer, as well as what healthcare providers can do to help their patients through this transition. ... “‘During treatment, a woman's breasts are touched by a lot of medical professionals—the surgeon, plastic surgeon, radiation team, medical oncologist, and the physical therapy team,’ says Owen. ‘Suddenly what is typically a private and sensual part of the body becomes a clinical body part, and there can be trauma attached to that exposure. As healthcare professionals, we need to be aware of the vulnerability many of our patients are feeling in these physical exposures of clinical care. Early in the woman’s treatment I want to initiate a conversation about breast touch, what it has meant in the past, what it means in the moment, and ask her if it is mentally and physically acceptable for her partner to touch the breasts in a sensual way at this time.’ she says. ‘For many women during their time on active treatment, they are not connecting their breasts to thoughts of physical intimacy and may not want their partner to touch their chest. I find it helps for the partner to have some perspective about why sensual touch may be a struggle.’ If the woman decides that the breasts are a no-fly zone, Owen suggests the woman have a gentle conversation with her partner about her feelings and consider wearing a camisole to cover her breasts. The cami can serve as a reminder to her partner not to touch that area, while also providing the woman with ‘a sense of a protective shield.’” Read More.
