• There Is Sex After Breast Cancer

    IMAGE Many people express concern about sexual issues while they are undergoing cancer treatment. "If you have a good body concept before treatment and a good sexual relationship, this is the best predictor of a good outcome," says researcher Deborah Watkins Bruner, RN, PhD, who educates women with cancer on sexuality issues.
    No matter if you are undergoing treatment for breast cancer or are recently diagnosed, you may want information on sexual issues that you are facing now or that you are concerned about for the future.

    Dealing With Vaginal Dryness

    One side effect of chemotherapy can be vaginal dryness, the result of early menopause caused by damage to the ovaries during treatment. This can be overcome with the help of a lubricant. Although some lubricants are too thick and greasy, there are others that nearly mimic nature. Your doctor can recommend an effective lubricant for you to try.

    Experiencing Sex After a Mastectomy

    Losing a breast through a mastectomy can considerably impact your sex life. "Most women I've worked with still have a certain amount of emotional and physical sensitivity toward [anyone touching or seeing] the breast area," says social worker Les Gallo-Silver.
    No matter what feelings you are experiencing, you should not feel pressure to "love your scars" after mastectomy, notes psychologist Leslie R. Schover, PhD, in her book Sexuality and Fertility After Cancer . A woman can adjust just fine and still not feel comfortable having her partner see or touch her scars, says Schover.
    If you are feeling self-conscious, it may be tempting to avoid intercourse. For one patient who did not want her partner to see or touch her breasts after reconstruction, Gallo-Silver recommended that the couple both wear sexy pajamas to bed and simply massage each other's backs, avoiding each other's chests. The couple enjoyed the intimacy, and after additional counseling and exercises, began enjoying genital touch again.
    In his experience counseling cancer patients, Gallo-Silver sometimes finds that a partner is uncomfortable viewing or touching his partner's scar—but for different reasons than a woman may suspect. For one, he may worry that touching the mastectomy scar will hurt his partner. There are also psychological reasons.
    Meanwhile, a woman may assume that her partner's avoidance is a sign that he finds her undesirable. If you and your partner are experiencing this miscommunication, a sex therapist may be able to help you.

    Getting Into the Mood

    Even if you feel entirely comfortable with your sex appeal, the thought of sexual intercourse may not appeal to you. You may not feel the desire, or you may be experiencing the fatigue that can last long after chemotherapy is over. For whatever reason, the idea of sexual activity may seem daunting.
    You can resume intimacy—without the pressure of performance—with sensate focus exercises, which Schover describes in her book. The exercises are aimed at increasing in-the-moment sensation and decreasing any pressure you may feel to achieve orgasm or perform intercourse. The exercises can be broken down into three steps:
    • Step One—Your partner touches the back of your body for 15 minutes, and then the front of your body for another 15 minutes, avoiding your breasts and genitals. You then do the same for your partner.
    • Step Two—You touch one another for the same amount of time, but this time you can allow your partner to touch your genitals and breasts, and you can touch your partner's genitals.
    • Step Three—You follow steps 1 and 2, but this time you can receive and give orgasm if you choose.
    The sensations you share might include soft kissing, light touching, or massage—any type of touch that you or your partner enjoys.

    Not Feeling Ready

    Regardless of all the self-help information about reviving your sex life after breast cancer treatment, do not forget the most important point. If you do not feel like having sex, for whatever length of time, you do not have to.
    "Sex is not love," says psychologist David Bullard, PhD. "You can certainly have a loving, deep intimate relationship without a sexually intimate part to it. But if you miss it, if it has been interrupted by cancer treatment, and if it has been important [to you] in the past, there is help available for couples who want to resume the shared experience of sexual intimacy."

    RESOURCES

    American Cancer Society http://www.cancer.org/

    Breast Cancer Action http://www.bcaction.org/

    CANADIAN RESOURCES

    Canadian Cancer Society http://www.cancer.ca/

    Women's Health Matters http://www.womenshealthmatters.ca/

    References

    Body changes and intimacy. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/coping/life-after-treatment/page5 . Accessed June 14, 2011.

    Cancer treatment for women: Possible sexual side effects. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/cancer-treatment/SA00071/NSECTIONGROUP=2 . Updated June 26, 2009. Accessed June 14, 2011.

    Schover L. Sexuality and Fertility After Cancer. New York, NY: Wiley; 1997.

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