Ups and Downs of a Sex Life

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. 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 suckiest news. But the good news is there is sex after breast cancer!

Breast cancer has changed the way I see my body. Sometimes I feel very disconnected from my body. My body’s been through so much and it’s worked to get well, but there have been sacrifices.

It’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 you both expect. I actually got online so my husband and I could see what I was in store for.

The way your partner looks at your incision for the first time is something you’ll remember that forever. 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.’ Even though Glen and had seen the pictures, I was petrified that he would change his mind and not love me anymore because I no longer had real breast.

Communication is very 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, you waiting for him to tell you he wants sex, and he’s waiting for you 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. Discovering other areas of your body to help with arousal is important, rather than trying to “force” yourself to perform.

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. And this is most definitely I need to do. My sleepwear at this point looks like something my grandma would wear.

But even as I get comfortable with the “new me” in the mirror, other parts of my body have been causing me problems in the bedroom. Having estrogen-receptor positive breast cancer, I am taking hormonal therapy that have me in a menopausal state. The resulting vaginal dryness and other symptoms may make it painful to even think about having sex.

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. 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. 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, 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, 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.

I know some of you are like “too much information” and other are just not believing that I would even talk about my sex life or lack of. But you can’t just ignore it. You have to get it out in the open.

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