If you’re a woman going through cancer treatment, you’ve probably had to adapt to a lot of changes in your life. You might have seen some dramatic changes in your sex life, too – changes you might not have been prepared for.
Maybe you’re not able to have sex the way you used to. Perhaps you’re experiencing hormonal changes that affect your level of desire. Maybe you’re feeling confused about your partner or your relationship. Or you might be feeling anxious about starting a new relationship after cancer treatment.
No matter what you’re experiencing, it’s normal to be concerned about your sex life. Your sexuality is a part of who you are. Today we’ll look at some of the issues female cancer survivors face and some strategies to cope with them.
- Hormonal changes. For some women, cancer treatment causes menopause, the time when a woman’s ovaries stop producing eggs and her menstrual periods stop. Along with menopause come lower levels of two hormones, estrogen and androgen. Estrogen helps ready your vagina for sex by making it longer, wider, and lubricated. Androgen affects your sex drive. After menopause, these hormonal changes can cause vaginal dryness and tightness or a loss of desire. Talk to your doctor if you have any problems. For dryness, you may try water-based lubricants, a vaginal moisturizer, or vaginal hormones. For loss of desire, your doctor may prescribe small doses of androgens.
- Pain. Pain during sex is common for many women. Vaginal dryness and tightness or changes in the genitals from cancer treatment are common causes. Be sure to discuss any sexual pain with your doctor. He or she can give advice tailored to you. Talk to your partner about what does and doesn’t work for you. You may need to discover new ways of touching each other or try new positions and techniques to make the experience pleasurable for you. Try to be patient and open-minded.
- Fatigue. Breast cancer and its treatment can be exhausting. You might just feel too tired for sex. Try planning intimacy for times when you have more energy, such as the early morning or afternoon.
Lots of women feel anxious about changes that result from cancer treatment and how they’ll be perceived by others.
- Body image. Your body might look different from cancer treatment. Losing a breast or your hair, having scars from surgery, changes in weight – these can all make you feel less attractive. You may worry that these changes will turn off your partner. Some women feel better when they accentuate the positive. You might try a new style of clothes or makeup to give you a boost. Some women wear a breast form or try different skin treatments. Don’t forget that healthy eating and exercise can also make you feel better! Remember, too, that you are still you, beautiful inside and out. As the National Cancer Institute says, “Try to recognize that you are more than your cancer. Know that you have worth – no matter how you look or what happens to you in life.”
- Dating. Starting new relationships can be fun and exciting, but women in cancer treatment may feel anxious about it. When should you tell your partner about your cancer? How will he or she react? You can start by just enjoying time with your friends and family. Take part in activities you enjoy or try new ones. You might not meet a new partner, but it’ll boost your spirits and confidence to be out and about. When you do meet someone new, enjoy the experience. When the relationship becomes more serious, and when you feel that you trust the person, you can introduce the topic of cancer. Try practicing what you’ll say with a good friend and ask for feedback. Also think about the many ways that person may react and how you’ll handle them. Don’t assume that the person will reject you. If the relationship has a solid base with caring and trust, the person will likely want to be with you, cancer or not.
- Is it okay to have sex? Many women wonder whether it’s safe to have sex during or immediately after cancer treatment. Your doctor can best answer this question. If you’ve just had surgery, sex could pull at the stitches, so it might be best to wait awhile. Unusual bleeding is another concern. Some cancer treatments, such as radiation and chemotherapy, can interfere with your immune system and make you more susceptible to infections. Ask your doctor about any precautions you need to take.
- Radiation. Some women who have radiation therapy worry that they can pass along radiation to their partner. Again, this is a concern best addressed by your doctor. Generally, if the radiation comes from a machine outside your body, no radiation remains in your body. So in this case, you wouldn’t be passing radiation along to your partner. However, radiation from a radioactive implant placed in your uterus or vagina can be passed along to your partner, so it’s best to ask your doctor when you can have sex again.
Talk to your doctor.
Your doctor might not bring up sexual issues, but that doesn’t mean you can’t. Don’t hesitate to speak up! He or she may know the remedy. And even if your doctor doesn’t have all the answers, he or she can refer you to someone who does, such as a sex therapist or counselor. And there’s nothing wrong with seeing a specialist.
Talk to your partner.
If changes in your sex life are troubling you, be sure to talk to your partner as well. Together, you and your partner can brainstorm ways to adjust your sexual repertoire. For example, if vaginal intercourse is uncomfortable, try oral sex or kissing and cuddling. (Read more about sexual pain here.)
You might also need more time to become fully aroused. If so, tell your partner what you need. Take advantage of that time to experiment and just enjoy each other.
Your partner might be nervous about sex, too, afraid of hurting you or doing something “wrong.” If an activity hurts, by all means say so. But if you miss an old activity or touch, let your partner know.
Know that you are not alone. Depression and anxiety, common in breast cancer patients and survivors, can take a toll on your sex life as well. If you think you need help, consider therapy or a support group. Couples counseling and sex therapy may also help you work out changes in your relationship.
Remember, your sex life was likely important to you before cancer. There’s no reason it shouldn’t be important now. Cancer and its treatment shouldn’t prevent you from having healthy, fulfilling sex.
To learn more about breast cancer and sexuality, see these links:
“Changes in Your Sex Life”
(Last modified: June 13, 2017)
Schwartz, Dr. Pepper via PRNewswire
“Breast Cancer and Intimacy: Advice for Survivors to Address Sexual Dysfunction and Regain Confidence”
(October 16, 2018)