A breast cancer diagnosis can impact sexual health, relationships and self-image. Dealing with possible treatment side effects like hair loss, vaginal dryness, little or no libido and fatigue can prove challenging. It may take time to process and accept what is happening to you and how it impacts on your relationship.
Sexual health is an important part of your overall physical health so don't be afraid to discuss how your treatments are affecting your sex life. Intimacy with your partner is an important part of your recovery and a way for him or her to be there for and with you. Things may not be quite as dynamic as they were, but 'this too shall pass' and maintaining a good sex life is possible during treatment and recovery.
In this section:
Changes in your body
Talking about sex
Changes in your body
Breast cancer is hard on the body - physically, emotionally and spiritually. It's normal to feel 'changed', to lack confidence in your body and how you look. Some women say they feel 'less feminine' because treatments have side effects: surgery has removed part or all of your breast(s), chemotherapy has caused some major changes eg hair loss, fatigue, poor appetite or lowered sex drive, radiotherapy has caused changes too eg fatigue and skin sensitivity and hormonal treatments may have caused hot flushes, joint aches/pains or fatigue. If you're struggling with self-image and confidence during or following treatment for breast cancer, seeing a counsellor for a few sessions may help. Talk to your breast care nurse or GP for a referral.
Partial or total hair loss is a common side effect of chemotherapy treatments for breast cancer. Your oncologist will be able to give you more information for your individual treatment plan. After commencement of chemotherapy, your hair won't fall out all at once probably gradually at first, and then more rapidly over ensuing weeks. There is a government subsidy for wigs/hairpieces/headwear - your breast care nurse or oncology nurse can provide details. Local wig suppliers can help you choose a wig that is close to your hair colour and style. Even in summer you may find that you'll feel cold so having a beanie for day and night time use is a good idea. The good news is that your hair will start growing again even before cessation of treatment. It will return initially as very fine, baby-fluff hair, and then grow out. Most women find their hair is a slightly different colour or grey. It may be 'wiry' for some time until your natural hair texture returns. This is sometimes referred to as “chemo curls”.
Talking about sex
Treatments for breast cancer can cause changes which impact sexual function and intimacy. Physical changes resulting from treatment-induced menopause may reduce sexual desire and cause vaginal dryness/discomfort during intercourse. Other symptoms could be less intense/frequent orgasm, decreased urinary control, altered skin sensation, decreased shoulder/chest mobility and fatigue. Emotional changes from menopause may include: poor self-image, irritability, depression/moodiness, loss of cognitive functio, and disruption of sexual patterns/habits used prior to diagnosis. These changes can create barriers in a relationship: helplessness and frustration, embarrassment, misinformation and misunderstanding. Communication with your partner is an important part of getting through this stage of treatment.If you're in a sexual relationship - or thinking about one - there's no reason why your diagnosis should make you stop or reconsider. However, with all the changes your body is going through, your sexual motivation may be somewhat different than it used to be.
Try and talk with your partner about what you both want and how to keep your intimacy going. Maybe intercourse isn't for you right now but there are other ways of being sensual with each other. Talk, explore, break down the barriers ... and don't forget the role of humour and fun. Here are some tips:
Try different positions - post surgery you might find your arm/chest area is sore for a while - use cushions to ease discomfort
- Be an 'active listener' - discuss needs and frustrations. Encourage your partner to tell you how it is for him/her because they may be confused about sex, afraid of hurting you and needing some guidance.
- Talk about your cancer and how it is affecting you physically. Talk outside of the bedroom, visit a favourite place and discuss non-sexual aspects of your relationship too.
- If experiencing vaginal pain or discomfort during sex, see your GP to check that this is not due to infection. Use of water-based or silicone-based lubricants can help to overcome vaginal dryness but avoid oils (such as baby oil) as they can cause vaginal inflammation. You may notice an increase in bladder infections after sex - see your GP if this happens for you. Ask for a referral to a Gynaecologist if your physical issues are not improving.
If you and your partner are unable to find a way forward sexually, a few sessions with a Sex Therapist could be really helpful
Some women let potential partners know right away, that they have had breast cancer or are undergoing treatment. Others may prefer to wait until the time for intimacy is closer. Whatever feels right to you. If the person backs away after hearing your news, then they probably aren't the real deal.
The right partner will be understanding about breast cancer - that person will not see your situation in a negative light.
If you're finding it hard to broach the subject in a new relationship, seeing a professional counsellor can help. Your Breast Care Nurse can provide advice too. You may wish to discuss the impact of your treatment on your sexuality with your medical team (even if you're not in a relationship).