By Jennifer King
Adapted from Jennifer’s book, ‘Holding Your Hand: A Breast Cancer Companion’, a guide with ways of coping with fears of the unknown path ahead, from someone who has dealt with the emotional and physical challenges and found some sort of solace on the way to recovery.
Sex may be something that isn’t frequently discussed by doctors or oncologists or even friends, but the sexual changes and adjustments you go through following a breast cancer diagnosis can be enormous for you and your partner, depending on how big a part it was in your life before diagnosis and treatments.
Personally, I found that sex was the last thing on my mind as I struggled with the new realities of breast cancer and the effects of the treatments. My breast cancer was ER positive, so it became important to decrease the estrogen in my body which I found virtually killed my libido. Cuddling and just being held was a big comfort to me and I expressed this to my husband. Being open and communicating this need helped us, and we focused on the pleasure and closeness this brought to both of us.
Some form of sexual dysfunction is common in most women suffering from breast cancer. The effects of treatment, self-esteem and body image, anxiety and fear as well as fatigue kills the libido in most women. Some women who have had a mastectomy feel a sense of disconnection with their body and see themselves as being deformed and unsexy. The following tips are offered to help you regain a sense of self and maintain good sexual health as a breast cancer patient. Some are tips that I have tried, while others are tips that I have heard from other sources. Feel free to try only what you are comfortable with.
- Finding clothing and lingerie that makes you feel attractive and desirable helps to ignite the coals of desire to a point. I found some lovely sexy nighties that added spice to the moment and covered my mastectomy scar and missing breast. Erotic videos as well as literature can also help you feel more sexual. Sex toys, like vibrators, might also be a good addition to your sex life.
- Pampering yourself can also help to make you feel special and lovable. Bubble baths with candles are a nice way to enjoy your body.
- The decrease of estrogen creates a loss of lubrication and vaginal dryness which can make sex uncomfortable. Vaginal dryness can be managed with regular use of a vaginal moisturizer with supplemental vaginal lubricants for sexual activity. Look for vaginal moisturizers that are water-based gels and free of hormones. These are designed for regular use (two to three times a week) to maintain or replenish vaginal moisture. I have found that ‘Replens’ has helped me, but there are several other brands available. In addition to regular use of a moisturizer, a vaginal lubricant used immediately prior to sexual activity can increase comfort.
There is a quite costly laser treatment for vaginal dryness called the ‘Mona Lisa touch’ with a possible improvement after three to five sessions. I don’t know anyone who has tried it, but it could be an option.
Soap can apparently have a drying effect on the vagina, so bath washes without soap are recommended. This can also help with mild incontinence that can sometimes develop.
- I found exercise helped me feel more vital and less frumpy as well as keeping my body in reasonable shape. I tried to keep a daily exercise routine of yoga and pilates stretches as well as a walk or bike ride.
- Counselling is another option that might help to look at the emotions that are creating the loss of positive body image.
- Communicating with your partner is really important to help your partner understand how you are feeling physically and emotionally and what you need. My husband and I would schedule days for lovemaking which might just be cuddling but making time for intimacy was important. I would set the scene with candles and soft light which also helped me feel the missing breast was less obvious. Scheduling an intimate date might feel contrived, but it takes the pressure off feeling like you should be more available and interested in sex all the time.
While sexual health will be different for everyone, I think intimacy is an important aspect for healthy relationships. It is worth making the effort to have honest conversations and finding what works for you and your partner. Regardless of what tips and steps that you take, try not to be too serious about the outcome of your lovemaking. Enjoying each other and the intimacy from open and honest communication can be quite satisfying as the goal should be increasing and maintaining closeness.