Breast Cancer Self-Care and Recovery: Sexuality

What Is Sexuality?

Sexuality is the sum of feelings and behaviors we have about ourselves and others as sexual beings. It includes how we feel in our own bodies, how we feel being touched and touching, our thoughts and fantasies, how we move and what we say. It includes pleasurable and exciting sensations as well as kissing, masturbation and the wide spectrum of expressions of sexual intimacy.

Sexuality has very different meanings to each of us; how we think and act sexually may be affected by our religious beliefs, our cultures and our families' attitudes, as well as prior good and bad experiences with sensuality, intimacy and sex.

How May Sexuality Change After Breast Cancer?

Sexuality also may change with a breast cancer diagnosis, treatment and recovery. Some women report little or no change in the meaning and acting out of sex or intimacy. This may be true for women with either active or inactive sexual lives. Some women talk about a deepening of intimacy born of the crisis of illness. Many women share experiences of decreased libido (sex drive), a sense of vulnerability in one's body and a feeling of needing to heal from the trauma of diagnosis, procedures and treatment.

There are specific symptoms that women may experience associated with treatments that have direct impact on sexual thoughts and behavior. Surgery can be associated with pain, a decrease in mobility and a change in how one's body looks and feels to oneself or a partner. Radiation therapy can be associated with breast discomfort and fatigue. Chemotherapy can result in nausea, vomiting, fatigue and symptoms associated with menopause, such as vaginal dryness, hot flashes and sleep disturbance.

Some authors have suggested that a change in sex drive may be related to a decrease in testosterone levels as well as to decreasing levels of estrogen. Changes in self and body image may be linked to hair loss, weight gain and loss of or change in the breasts.

Our thoughts and feeling have enormous impact on our sexual selves. Anxiety, fear, depression, worrying and many other feelings may decrease or interrupt sexual expression. It is, most of all, just "human" that our most intimate feelings may undergo big changes sparked by the diagnosis of breast cancer.

Not all of these changes are bad and hard. The growth and insight that can emerge from exploring sensuality and sexuality may be stunning. Women have told stories of enriched relationships, deepened meaning to touch, a more powerful, alive and even joyous sense of one's own body.

What Can I Do?

Talk to your doctors and nurses about symptoms that you are experiencing. This may help to decrease or treat them. For example, sexual intercourse with vaginal dryness is very uncomfortable and certainly not pleasurable; vaginal lubricants and some medications may reduce this menopausal side effect. If anyone you speak with is not comfortable or knowledgeable, don't give up; find someone who is.
Think about and explore the kind of emotional support that best works for you. Some people are benefited by one-to-one therapy, others find their deepest help in support groups, others blossom in the setting of the creative arts, writing in a journal, going on a retreat or having "heart-to hearts" with relatives and friends.
Read, research and talk to others. Believing that you are the only person in the world with sad, hard, complicated or confused feelings, thoughts and behaviors about sex can be isolating and lonely.
Understand that it is hard for most people to talk about sex. Starting the conversation with friends, other women with breast cancer, health care providers, therapists and spouses, partners, and lovers is a potentially life-changing event. You may feel better; you will probably feel less alone and you may feel more at home with yourself, your body, sexuality, sensuality and intimacy.
Don't feel pressured to be any more or less sexual than you want to be. There is no "right" way to be; what's important is to explore what you want and be able to work with what you want to change.
Remember that you deserve pleasure; only you can define that for you.