Many women report a loss of interest in sex after breast cancer treatment. There are simple solutions that can help.

Chemotherapy, hormone therapy and breast surgery all have an impact on sexuality. Barriers to sex after breast cancer can range from vaginal dryness and painful intercourse to chronic fatigue and the loss of libido. Happily, there are solutions, sometimes simple ones, for making sex after breast cancer treatment enjoyable again.

 

When desire disappears

 

Common problems

• Pain from surgical scars or infection
• Chronic fatigue (extreme tiredness)
• Fears, worries, general malaise from the disease
• Feeling less attractive because of the changes in the breast
• Chemotherapy and hormone therapies reduce estrogen and testosterone levels and may decrease libido.

 

What can help

• Share your thoughts and feelings with your partner about your lack of desire, as well as your wishes and needs. Ask your partner what they would like.
• Techniques such as meditation and yoga can help you relax.
• Develop erotic fantasies alone or together.
• Hugging and massage. Mutual touching can help you relax, sexually stimulate you physically and emotionally, and bring you closer to your partner.
• Some women find that masturbation helps. It allows you to rediscover your body without pressure and at your own pace.

 

When you have vaginal dryness

 

Possible Causes

• Surgery or radiation in the pelvic area
• Estrogen deficiency due to hormone therapy
• Lack of sexual desire

 

What can help

• Vaginal lubricants and moisturizers can alleviate painful intercourse after breast cancer treatment
• Estrogen applied directly to the vaginal area promotes the circulation in the vaginal tissue and relieves dryness of the mucous membrane. Unlike lubricants, which are used only during sex, it is usually applied regularly 1-3 times a week. Since the body absorbs a small amount of estrogen, it is not recommended for everyone. Ask your doctor or breast care nurse if this is suitable for you.

 

When you have itching or a burning sensation in the vagina

 

Possible Causes

• Radiation to the pelvic area
• Chemotherapy
• Hormonal changes that upset the vaginal environment

What can help

• Wearing underwear made from natural fabrics such as cotton or silk rather than synthetic materials reduces the risk of infection. Loose fitting garments are less irritating than tight lingerie or thongs.
• Wash your genital area with water only. Soaps and lotions can interfere with the balance of bacteria and pH levels in the vagina.
• If you think you have an infection, speak to your doctor.

 

 

When you experience painful intercourse

 

Possible Causes

• Surgical scars
• Vaginal dryness or infection (see above)
• Vaginismus (spasm of the vagina) – because of anxiety or emotional stress

 

What can help

• Talk to your doctor to find out what is causing the pain.
• A gentle massage can help scar pain. Preferably use a non-perfumed cream or oil.
• Stretching and relaxation exercises increase physical well-being. Avoid jerky movements when your scars are still fresh.
• Finding the right position can help prevent painful intercourse after breast cancer treatment. For example, 1) Lying next to your partner avoids pressure on the operated breast. 2) Sitting astride your partner can help you control the intensity and rhythm of the movements.
• If your fears aren’t lessening over time, talking to a sex therapist can help.
• Give yourself time to recover after surgery and don’t put pressure on yourself.

 

 

When the tiredness doesn’t go away

 

Possible Causes

• Chronic fatigue – Extreme tiredness is a common side effect of cancer treatment.
• Anemia

 

What can help

• Talk to your doctor and identify the cause of the fatigue.
• Stay active. Although it may sound strange, physical activity can reduce fatigue. Accepting that this exhaustion is normal after treatment can also help.

 

When your body has changed

 

Possible Causes

• Surgical scars
• Breast-conserving surgery / lumpectomy (asymmetry)
• Reconstruction
• Mastectomy

 

 

What can help

• Share your worries with your partner. Remember that sexual attraction is not just based on external factors. Discuss your feelings about your scars or missing breast with each other.
• Get to know each other again, with hugging or mutual massages, for example.
• Create an atmosphere with low lighting.
• Pretty lingerie or a breast form can help support your confidence.
• Relaxation techniques, exercise or dancing, can help you get comfortable with your body again.
• It often helps to share your experiences with others who are going through the same thing.

 

Disclaimer

The type, course and treatment of breast cancer vary from woman to woman, and everyone reacts individually. We strive to provide you with comprehensive, factually correct and understandable medical information. However, this cannot replace a consultation with or treatment by a doctor or medical practitioner. The information we provide can help you prepare for a doctor’s visit and supplement the information they give you.