Intimacy

One of the least common topics discussed concerning breast cancer treatment is that of intimacy issues that may occur as a result of treatment. Women that have a mastectomy may feel very uncomfortable or even embarrassed of their new physical appearance after surgery. Chemotherapy, radiation therapy and hormone therapy can also cause changes in appearance that affect intimacy.

In a study of 549 women between the ages of 22 and 50 years old that had completed breast cancer treatment and was in a stable relationship, it was found that over 50% of them identified two or more body image issues after therapy. These included change in physical appearance after mastectomy, scarring, hair loss, breast reconstruction and weight loss. In addition, 24% of the women reported that their intimacy issues were directly related to their inability to experience intimacy as they did before.1

Physical Intimacy Issues

Breast cancer patients should anticipate that there is the potential for normal but very challenging intimacy issues that could arise after treatment. These changes are not always preventable, but there may be ways to minimize them.

Sexual intercourse may be difficult or even impossible for some women because of vaginal dryness. This is most commonly associated with chemotherapy and is most noticeable during treatment. The most significant difficulties occurred in women that experienced early menopause as a result of hormone or chemotherapy. 2

Vaginal dryness can be managed using lubricants that are available over-the-counter. Some women also find that using a vaginal moisturizer on a regular basis can help alleviate minor dryness during and after treatment. Avoid any products that contain perfumes or dyes as they may cause irritation.3

Hormone replacement therapy may be an option for women who cannot tolerate the symptoms of menopause, such as hot flashes, vaginal dryness, weakness, and fatigue. Topical hormones are also available and can be applied to the vaginal area to prevent dryness.

Emotional and Psychological Intimacy Issues

There may also be a natural fear for the partner, as to how they approach the breast cancer survivor intimately after treatment. Being able to talk to your partner about your concerns and help them understand that intimacy is positive will help in your recovery, and it will also strengthen your relationship with each other.

Women typically report decreased libido during treatment and immediately afterwards. However, ongoing dissatisfaction with body image often contributes to lack of sexual intimacy well after treatment is completed. Engaging in the following activities may help women become more comfortable with their bodies:

  • Look at your body in a mirror and recognize it as a whole without focusing on your breasts
  • Touch your body and learn which sensations you now enjoy
  • Talk to your partner about your fears and concerns with being intimate
  • Express your need for emotional and physical intimacy with your partner
  • Talk to a therapist or counselor that works with breast cancer patients concerning issues with intimacy

Women that have difficulty accepting the changes in their body are more likely to become depressed after treatment.4  You are not alone in this matter and you will find that thousands of women are also dealing with intimacy issues as a result of their breast cancer treatment.

References

1 Fobair, P., Stewart, S. L., Chang, S., et al. (2006). Body image and sexual problems in young women with breast cancer. Psycho-Oncology , 579-594.

2 Burnwell, S. R., Case, D., Kaelin, C., & Avis, N. E. (2006). Sexual Problems in Younger Women After Breast Cancer Surgery. Journal of Clinical Oncology , 2815-2821.

3 American Cancer Society. (2004). A Breast Cancer Journey: Your Personal Guidebook. Atlanta: American Cancer Society.

4 Eun-Young, J., Kim, S., Soon-Bok, C., et al. (2011). The Effect of a Sexual Life Reframing Program on Marital Intimacy, Body Image, and Sexual Function among Breast Cancer Survivors. Cancer Nursing , 142-149.

This article was originally published on July 27,2012 and last revision and update of it was 9/2/2015.