Sexuality after treatment for breast cancer
Breast cancer and its treatment can affect your sex life and how you see yourself as a woman (body image). Sexual difficulties can happen as a result of the physical and emotional effects of cancer and its treatment.
You may lose interest in sex, feel unattractive or worry that you’ll never be able to be sexually active. For some women, these problems continue well after treatment is over.
Try not to think that sex is never going to be as important in your life as it was before. Bringing sex back into your life can involve a period of adjustment for you and your partner. After treatment, some women continue to have problems with their body image and self-esteem. Others may be left with a low sex drive (libido) or have sexual difficulties as a result of the physical effects of treatment. Usually, women find that with time most difficulties can be overcome.
Many people find it difficult to talk about sexual issues because they feel embarrassed or self-conscious. Your doctor or nurse specialist will be used to talking about these things and can advise you about where to go for specialist help and support.
Some of the physical effects of your treatment may make having sex difficult or reduce your sex drive.
Our section on sexuality and cancer has detailed information about the impact cancer can have on sexuality and ways to cope.
You may feel too exhausted to have sex during treatment and for a while afterwards. Most people find that this gradually improves, but occasionally it can last for months or even longer. If you’re very tired, it might help to have sex differently, for example, less energetic positioning or quicker sexual contact.
Menopausal symptoms can cause vaginal dryness and hot flushes, which can make having sex difficult and reduce your sex drive. Using gels and creams can help ease discomfort during intercourse. Managing hot flushes and other menopausal symptoms may help to improve your sex drive.
If you have problems with pain, this may affect your sex drive. Some women have pain in their chest and shoulders after surgery or radiotherapy. Controlling the pain may improve your desire to have sex. Supporting painful areas with pillows and avoiding positions where your weight rests on your chest or arms may help.
Treatments for breast cancer may not affect your physical ability to have sex, but the emotional effects can reduce your sex drive. Surgery to remove part or all of the breast can cause problems with how you see yourself as a woman. You may feel insecure and worry if your partner will still find you sexually attractive.
These anxieties may result in difficulties with your partner or make you feel anxious about new relationships. Occasionally, problems may arise because partners are struggling with changes. However, your partner may not have a problem with your changed appearance, and it can be helpful to try to discuss it if you feel that there is awkwardness between you.
If you’re feeling self-conscious about how you look, talking with your partner about how you feel can help you regain some confidence. Partners are often concerned about how to express their love physically and emotionally after treatment.
Cuddles, kisses and massages are affectionate and sensual ways of showing how much you care for someone, even if you don’t feel like having sex. If you feel very self-conscious, making love while partly dressed, or keeping the lighting low may be better for you.
Our section on sexuality and cancer, discusses ways of dealing with the physical and emotional changes that cancer treatment can cause.
Let your doctor or nurse know if you’re having problems with your sex life. They may be able to reassure you about your concerns. If you feel uncomfortable talking to your doctor or nurse, you may want to call us.
Some people may find it helpful to talk to a sexual therapist. You can contact a therapist through the College of Sexual and Relationship Therapists.
Changes in your appearance
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If you feel less confident and attractive because your operation has changed your appearance, it may be possible to have further surgery to improve it. Breast reconstruction or surgery to help improve the shape of your breast can help to restore your self-confidence, feelings of femininity and sexual attractiveness.
Many women have reconstruction done years after their initial breast operation. Your specialist or breast care nurse can discuss this further with you and also arrange a referral to a plastic surgeon.
If your prosthesis is no longer a good fit, you may feel less confident about how you look. You can have a reassessment, even if your prosthesis is still in good condition. From time to time, new prosthesis styles are developed.
Even getting a new bra fitted in a different style can improve how you look and feel. Breast Cancer Care has helpful information about prosthesis, underwear and clothing.