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.
00:00:00,000 --> 00:00:02,674
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It is not the case that once a woman
is diagnosed with breast cancer,
00:00:07,234 --> 00:00:10,910
they can't have sex or shouldn't have sex.
00:00:10,910 --> 00:00:13,330
For many, it is a great stress reliever,
00:00:13,330 --> 00:00:17,520
even while undergoing this very
difficult set of treatments.
00:00:19,800 --> 00:00:23,168
00:00:23,168 --> 00:00:25,810
There are various treatments for
00:00:25,810 --> 00:00:29,580
Many of them can affect the hormonal
environment in a woman's body.
00:00:29,580 --> 00:00:32,670
For hormonal receptor positive cancers,
00:00:32,670 --> 00:00:35,900
the treatment is actually
directly blocking hormones.
00:00:35,900 --> 00:00:39,718
And that puts women, even young women,
in a state of menopause.
00:00:39,718 --> 00:00:44,900
Even the non-hormonal treatments,
like chemotherapy, can affect the ovarian
00:00:44,900 --> 00:00:49,920
function and can also put the patients
in a temporary state of menopause.
00:00:49,920 --> 00:00:53,080
It is extremely common that a woman
will come to me either during
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cancer treatment or after they have
completed breast cancer treatment.
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We will discuss all of the different
issues in terms of their comfort and
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00:01:02,110 --> 00:01:05,380
The first thing that I recommend is
that they have an open discussion
00:01:05,380 --> 00:01:06,420
with their partner.
00:01:06,420 --> 00:01:08,950
A frank discussion about expectations,
00:01:08,950 --> 00:01:12,870
desires, what is comfortable
is really important.
00:01:12,870 --> 00:01:17,380
I recommend that most
women try to explore and
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see what is comfortable for themselves.
00:01:19,640 --> 00:01:22,970
Self-exploration can really
aid in that process.
00:01:22,970 --> 00:01:27,740
Along with the changes in hormones and the
stress of going through the treatment for
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breast cancer, it is really common for
women to have pain during sex.
00:01:32,000 --> 00:01:37,170
Vaginal dilators are a very
useful tool to help ease
00:01:37,170 --> 00:01:40,200
up the muscles and
make it more comfortable.
00:01:40,200 --> 00:01:42,730
Vaginal dryness is one of
the most common issues.
00:01:42,730 --> 00:01:46,820
And that is something that can
affect them not only during sex but
00:01:46,820 --> 00:01:48,040
also throughout the day.
00:01:48,040 --> 00:01:51,430
I would recommend that a woman
try a vaginal moisturizer.
00:01:51,430 --> 00:01:55,170
And adding a lubricant is
typically a good idea.
00:01:55,170 --> 00:01:59,410
If a woman needs it, vaginal estrogen is
an important part of the treatment for
00:01:59,410 --> 00:02:00,099
00:02:01,310 --> 00:02:03,840
If you have recently gotten chemotherapy,
00:02:03,840 --> 00:02:06,720
then you may wanna use some
form of barrier contraception,
00:02:06,720 --> 00:02:11,150
like a female or male condom to
prevent exposure to a partner.
00:02:11,150 --> 00:02:15,380
Not all chemotherapy agents
are present in vaginal secretions, so
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that is something that you could
talk to your oncologist about.
00:02:18,630 --> 00:02:23,174
The last thing that you think you're
gonna think about is your sexuality and
00:02:23,174 --> 00:02:24,930
00:02:24,930 --> 00:02:29,210
That is actually a very important
source of strength for many women.
00:02:30,260 --> 00:02:35,955
Once it is something that is discussed
with a partner and a plan is set in place,
00:02:35,955 --> 00:02:41,066
I do hear that improvements start
to happen pretty quickly, as well.
00:02:41,066 --> 00:02:44,159
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.