Sexuality

Changes to sexual well-being can be one of the most problematic aspects of life after breast cancer, with the impact lasting for many years after treatment, associated with serious physical and emotional adverse effects. 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. 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. The sexual side effects of breast cancer can linger long after treatment stops. A 2007 follow-up report on young breast cancer survivors, conducted by researchers at the University of California-Berkeley, found that some women reported persistent sexual difficulties five years after their treatment. According to the National Cancer Institute, about one out of every two women who’ve undergone breast cancer treatment, experience long-term sexual dysfunction.


But even as you get comfortable with the “new you” in the mirror, other parts of your body may be causing you problems. 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.


Here are some simple strategies to improve your sexual health and help you cope with your body image changes:

    • Vaginal moisturizers. These aren’t lubricants, which are intended for use during sex. Instead, they’re like the moisturizers you use on your face and hands, to benefit the tissues themselves. They are introduced as a suppository into the vagina adding moisture back into the vaginal space and giving it that natural elasticity. If you are experiencing a stretching, painful sensation like the skin is going to split, you don’t have enough moisture.
    • Lubricants. Lubricants should be combined with regular, ongoing use of vaginal moisturizers for best results.
    • Exercises. The classic Kegel exercises, tightening and releasing the sphincter muscle as you do when you urinate, are also great for making intercourse easier. If you do Kegels right before intimacy, you fatigue the vaginal muscles causing them to relax.
    • Lingerie: 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. At the same time, it can help to conceal areas you’re still shy about.

 

Websites

http://www.webmd.com/breast-cancer/features/breast-cancer-sex-and-intimacy?page=3

http://www.mskcc.org/cancer-care/adult/breast/sexual-health

http://www.breastcancerpartner.com/intimacy.shtml

References

Psychosocial adjustment and marital intimacy among partners of patients with breast cancer: a comparison study with partners of healthy women.
Moreira H, Canavarro MC.
J Psychosoc Oncol. 2013;31(3):282-304. doi: 10.1080/07347332.2013.778934.

The Acceptability, Feasibility, and Efficacy (Phase I/II Study) of the OVERcome (Olive Oil, Vaginal Exercise, and MoisturizeR) Intervention to Improve Dyspareunia and Alleviate Sexual Problems in Women with Breast Cancer.
Juraskova I, Jarvis S, Mok K, Peate M, Meiser B, Cheah BC, Mireskandari S, Friedlander M.
J Sex Med. 2013 May 1. doi: 10.1111/jsm.12156. [Epub ahead of print]

Psychosexual functioning of women after breast cancer therapy.
Mroczek B, Kurpas D, Grochans E, Kuszmar G, Rotter I, Zułtak-Baczkowska K, Karakiewicz B.
Psychiatr Pol. 2012 Jan-Feb;46(1):51-61. Polish.

Subjective sexual well-being and sexual behavior in young women with breast cancer.
Kedde H, van de Wiel HB, Weijmar Schultz WC, Wijsen C.
Support Care Cancer. 2013 Jul;21(7):1993-2005. doi: 10.1007/s00520-013-1750-6. Epub 2013 Feb 22.

Sexual dysfunction in young women with breast cancer.
Kedde H, van de Wiel HB, Weijmar Schultz WC, Wijsen C.
Support Care Cancer. 2013 Jan;21(1):271-80. doi: 10.1007/s00520-012-1521-9. Epub 2012 Jun 20.

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