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Breast Cancer: Sex and Intimacy

There's no denying that the sexual side effects of breast cancer can linger long after treatment is over, but there is sex after breast cancer.

Sex and self-image continued...

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 sex, and he’s waiting for her to touch him.” Your partner may be afraid of hurting you, or afraid that you’ll think he’s pushing you to have sex when you’re not ready simply by asking about it.

If your breasts were major erogenous zones for you before surgery, you may be feeling particularly bereft after a mastectomy or even a lumpectomy. Shockney suggests taking the pressure off by exploring and discovering other areas of your body, rather than trying to “force it” in areas where you still have performance or body image issues. “For some women, the diminished arousal in areas of a newly constructed breast or scar tissue might serve as a painful reminder that their sex life has changed,” Shockney says. Instead, think of areas like shoulders, ears, and knees as new hot spots for intimate touch.

If you’re still not comfortable with your new body, that’s what lingerie is for! There’s nothing wrong with getting a little help. A soft, satin nightie can be sexy and arousing. At the same time, it can help to conceal areas you’re still shy about.

Or you can get even more creative. “I asked a patient to try using a feather boa to help her feel sexy, and at the same time keep her scars from being so evident. She loves it!” says Shockney. “It’s all about finding what you’re comfortable with.”

Coping with changes

But even as you get comfortable with the “new you” in the mirror, other parts of your body may be causing you problems in the bedroom. You may go through temporary menopause because of chemotherapy. Or if you have estrogen-receptor positive breast cancer, you may be taking hormonal therapy that can leave you in a menopausal state for years. The resulting vaginal dryness and other symptoms may make it painful to even think about having sex.

“A lot of women I see are afraid to have sex,” Carter tells WebMD. “They’re really struggling. And it’s a shame, because there are wonderful, simple strategies to improve your sexual experience that, taken together, can work wonders.”

Your “getting my groove back” tool kit should include:

  • Vaginal moisturizers. These aren’t lubricants, which are meant to be used during sex. Instead, they’re like the moisturizers you use on your face and hands, to benefit the tissues themselves. “They’re introduced as a suppository into the vagina adding moisture back into the vaginal space and giving it that natural elasticity,” says Carter. “It’s meant to be absorbed, and it helps the vagina to have more health and moisture for several days.”
  • Lubricants. You definitely still want a lubricant for use during intercourse, says Carter. But lubricants should be combined with regular, ongoing use of vaginal moisturizers for best results. “If you’re feeling a rubbing or burning sensation during intercourse,” Carter says, “you don’t have enough lubrication. If it’s a stretching, painful sensation like the skin is going to split, you don’t have enough moisture.”
  • Exercises. The classic Kegel exercises -- tightening and releasing the sphincter muscle as you do when you urinate -- that so many women use during pregnancy are also great for making intercourse easier. “If intercourse has been painful,” Carter says, “you may tighten up in anticipation of the pain. If you do Kegels right before intimacy, you fatigue the vaginal muscles and it is more open.”
  • Vaginal dilators. A sex therapist, like Dr. Carter, can teach you how to use these dilators, which help gently stretch the vaginal tissue.

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