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 screeching halt.

Treatments can bring on 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. And 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, found that some women reported persistent sexual difficulties five years after their treatment had ended. And according to the National Cancer Institute, about one out of every two women who’ve undergone breast cancer treatment experiences long-term sexual dysfunction.

That’s the bad news. But 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. Carter is a licensed psychologist and the sexual health counselor for the sexual health program at Memorial Sloan-Kettering Cancer Center. “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 center 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.

A great bookthat can help is Show Me: A Photo Collection of Breast Cancer Survivors’ Lumpectomies, Mastectomies, Breast Reconstructions and Thoughts on Body Image. It was created by women in a cancer survivors’ group at Penn State. Although it is currently unavailable, the fourth edition is scheduled to be released in 2009.

“The way your partner looks at your incision for the first time,” says Lillie Shockney, RN, “you’ll remember that forever.” Shockney is administrative director of the Johns Hopkins Breast Center and a breast cancer survivor herself. “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.”