Sexuality Issues

With breast cancer you have to deal with many changes in your life. Over time, who you are, how you feel about yourself, and your relationships may all change. In this section you’ll find a discussion of some of the changes you may have that are related to your sexuality. You will also find ideas on how to deal with those changes as well as resources you can use.

You may feel awkward talking about sexual issues. You might also find it hard to be honest about how you feel. Your partner, doctor, or nurse may wait for you to bring up the subject of sex. They don’t want to make you feel uncomfortable. Feel free to ask questions and talk about your sexual issues or concerns. It might be helpful to talk to social workers, counselors, or other women in support groups.

When you think about the effects cancer may have had on your sexuality, ask yourself the following questions:

How has my illness changed the way I see myself and feel about myself?
How has my illness interfered with my role as partner or mother or...?
How has my illness affected my sexual functioning or response?

Changes

Many short- and long-term changes take place with cancer treatment. Many of these changes can affect your sexuality. They may be temporary. Or they may last a long time. The effects of different treatments can change how you feel, look, and function. Some side effects you may experience include:

changes in body image such as hair loss
weight changes
menopause
fatigue
pain
anxiety

You may experience:

low sexual desire
vaginal dryness
vaginal shortening
vaginal narrowing
painful intercourse
trouble reaching orgasm
infertility

All of these changes can affect your sexuality. They can also affect your ability and interest in sexual activity. Sexuality not only refers to sexual intercourse, but other means of sexual expression. For example, it also refers to touching and kissing. Intimacy refers to the physical or emotional closeness you share with another. Self-esteem and body image are important factors that define how you feel about yourself.

Whether changes are short-term or long lasting, you can find ways to feel good about yourself and to be intimate with your partner. Be patient and give yourself time. Here are some tips to help you cope with these changes:

Focus on physical recovery. That includes your diet and physical activities.
Ask your doctor or nurse about maintaining or resuming sexual activity.
Include your partner in discussions.
Report vaginal discharge or bleeding, fever, or pain to your doctor or nurse.
Choose a time for intimacy when you and your partner are rested and free from distractions.
Create a romantic mood.
Try different positions until you find one that is more comfortable and less tiring for you.
Use pillows for comfort.
Use a water-soluble lubricant (Astroglide, K-Y jelly, Lubrin), if needed for intercourse.
Use dim lights, wigs, lingerie, and other things to cover wounds or scars if body image concerns keep you from been intimate.
If pain symptoms or nausea prevents you from being intimate, take medications 30-60 minutes before emotional closeness.
Remember that cancer is not contagious.
Use birth control during cancer treatment if needed.
Remember that being intimate will not cause the cancer to come back or grow.
Remember that your partner is also affected by your cancer, so talk about both of your feelings and fears.
Explore different ways of showing love such as hugging and holding, stroking and caressing, talking.
Discuss treatment options with your health care team if you have menopausal symptoms because of therapy.
Find humor where you can.

You may be overwhelmed with the information you receive from your doctor. But it is important to take the time to gather as much information as you can. Here are some questions to ask the doctor.

Sexuality Questions

How will my cancer and its treatment affect my desire for sex and my sexual function?
How long will these changes last?
What can I do about them?
Are there any restrictions that I should be aware of?