For starters, sex is not off-limits during treatment.
“It is not the case that once a woman is diagnosed with breast cancer, they can’t have sex or shouldn’t have sex,” says Dana Shanis, MD, gynecologist at Rittenhouse Women’s Wellness Center in Philadelphia. “For many, it is a great stress reliever, even while undergoing this very difficult set of treatments.”
In a 2014 study by researchers at Drexel University, 77 percent of the surveyed breast cancer survivors qualified for sexual dysfunction. Additionally, low body image among the breast cancer survivors was worse than average rates; those with mastectomies or post-treatment weight gain were particularly at risk for greater body dissatisfaction. Learn more about body image after breast cancer here.
Physical changes to a woman’s appearance can affect their sexuality and general confidence. However, there are also changes on the inside that can affect the sex life of a woman during and after breast cancer treatment. “There are various treatments for breast cancer,” says Dr. Shanis. “Many of them can affect the hormonal environment in a woman’s body.”
For example, hormone receptor-positive cancer refers to a type of breast cancer that grows in direct response to estrogen or progesterone. This type of breast cancer is usually treated using hormone therapy treatment, which blocks the hormones and can cause a temporary state of menopause, according to Dr. Shanis.
Because of the drop in hormones, your vagina may take longer to get moist, and the thinning of the vaginal lining may make it less flexible, according to the American Cancer Society. These two factors can result in more pain during sex.
Other treatments for breast cancer, like chemotherapy, can also affect ovarian function and cause menopause symptoms.
Tips to Improve Your Sex Life During Breast Cancer Treatment
Some women with breast cancer may find sex more painful or less enjoyable due to the symptoms of low estrogen and progesterone. Despite this, there are ways to counteract those symptoms and embrace your sex life during this time. Here are tips Dr. Shanis recommends to women during and after breast cancer treatment:
Talk about it. Have a “frank discussion about expectations, desires, [and] what is comfortable” with your partner, suggests Dr. Shanis. Even if your go-to routine is no longer comfortable or enjoyable, you can still explore new ways to give and receive pleasure.
Self-explore. Masturbation during or after breast cancer treatment can help reacquaint yourself with what is most comfortable. It is rare that cancer treatment would affect the nerves that help you reach orgasm or feel pleasure from touching, according to the American Cancer Society.
Broaden your horizon. Consider using a vaginal dilator (a device that can help with the width, depth, and elasticity of your vagina) if you’re experiencing pain during sex, which is common due to the hormone changes. Vaginal dilators “help ease up the muscles and make it more comfortable,” says Dr. Shanis.
Soothe and moisturize. “Vaginal dryness is one of the most common issues,” says Dr. Shanis, “and that is something that can affect them not only during sex but also throughout the day.” Dr. Shanis recommends vaginal moisturizers and water-based lubricants. For persistent dryness, your doctor may prescribe vaginal estrogen cream.
Use a barrier method. If you’ve recently had chemotherapy, consider using a female or male condom to prevent exposure to your partner. Not all chemotherapies can be transmitted through vaginal secretions, so ask your oncologist about your individual risk.
“The last thing that you think you’re going to think about [during breast cancer treatment] is your sexuality and your intimacy,” says Dr. Shanis. “But that is actually a very important source of strength for many women.”
For more on this, here are survivor’s confessions about sex after breast cancer.
Cancer, sex, and the female body. Atlanta, GA: American Cancer Society, 2017. (Accessed on November 26, 2018 at https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-women-with-cancer/cancer-sex-sexuality.html.)
Raggio GA, Butryn ML, Arigo D, Mikorski R, Palmer SC. Prevalence and correlates of sexual morbidity in long-term breast cancer survivors. Psychol Health. 2014;29(6):632-50.