It’s impossible to capture the myriad of experiences that breast cancer patients and survivors undergo on their cancer journey. But one aspect is nearly universal: the healthcare system generally fails to acknowledge and incorporate conversations about sexuality into its care.
I experienced this firsthand while working as a research assistant on a study with cancer patients. I witnessed very different reactions from providers and patients to the study’s single question asking if participants noticed any sexual side effects. While the healthcare providers’ responses ranged from apathy to ire, patients unanimously expressed gratitude that this portion of their experience was being acknowledged. Seemingly desperate to finally connect with someone about the impact of their diagnosis and treatment on their intimate lives, patients would spill their entire sexual history to me.
Nearly a decade later, I continue to hear from patients at workshops, in my counseling practice, and through my social media platforms that these patterns are holding fast. Additionally, multiple studies show that the majority of patients want their healthcare providers to talk to them about sex but that providers often do not.
Providers either feel that the topic is outside of their scope and refer patients to a urologist or OB-GYN, or providers voice concerns about offending their patients. Meanwhile, patients report past negative experiences or feeling embarrassed by bringing up sex with their provider. Underlying this all is the gross lack of sexual education that healthcare providers receive—an average of two hours or less in medical school. Meanwhile, patients still want to be having and enjoying sex. Everyone loses in this scenario!
So, while no single narrative or article can cover every scenario and patient—and some patients won’t want or be able to think about sex—here’s an overview of the impacts of breast cancer and its treatments on your sex life, plus how to begin feeling in the mood again.
Not only do patients’ intimate desires often go unacknowledged, but they are robbed of the healing power of pleasure. Amidst the chaos of any chronic illness, moments of pleasure are priceless. Beyond that, experiencing pleasure has been reported to reduce stress, pain, and nausea, as well as improve sleep—all outcomes that any patient can benefit from. I often say that pleasure isn’t the cherry on top of life that society repels it to, but rather a fundamental core of what drives us, supports us, and helps us survive.
When talking about breast cancer’s impact on your sex life, it’s vital we recognize that we aren’t only talking about sexual side effects. Both cancer and its treatment can cause changes in desire, arousal, and orgasm. However, non-sexual side effects like tiredness, nausea, body changes, etc., also impact one’s sex life. On top of that, being a patient can be exhausting, draining, and vulnerable. Many people report feeling betrayed by their body. Having a team of providers means tons of people examining, prodding, and poking you—it can be easy to feel like your body is no longer your own. There’s facing your morality, the stress of scheduling and finances, and so much more that often creates a context for sex that hits your sexual brake and is a total turn-off.
Reclaim Your Pleasure
Listen—I wish I had a single magic pill, technique, or sex toy that could do this for you. Unfortunately, that doesn’t exist. But what can help are these strategies that help you to create the ideal context for sex even amidst the chaos that can be cancer treatment.
Manage side effects and symptoms
Managing your side effects and symptoms can free your energy to focus on other things like sex. From nausea to pain, lymphedema to tiredness, be open and honest with your team. Now isn’t the time to put on a brave face or tell yourself things aren’t that bad. There is a lot that modern medicine can do to help you be more comfortable, and you deserve it.
Take advantage of all the resources available to you
Sex may be the last frontier in healthcare, but many cancer centers and nonprofits offer complimentary and alternative services such as massage, reiki, and aromatherapy. While the research is still out on the effectiveness of these treatments, they do help reduce stress and often feel good, too!
Connect with others
Cancer can be lonely. People don’t always know how to react or hearing the news causes them to freakout. Find people who get it. Maybe that’s your family and friends. And maybe that means seeking out support groups and online communities. Shared reality is a powerful stress reducer.
Commit to your pleasure in big and tiny ways
Request the tastier lunch. Splurge on the nicer wig. Put on some lipstick. Take a bath. Face the sunshine and breathe deeply. Read steamy romances (or whatever your “guilty pleasure” genre is). Watch all the reality TV you want. Cuddle some animals at a shelter or farm sanctuary. Have them play your favorite music during procedures.
Reflect on past pleasurable sexual experiences to look for themes that you can replicate
This practice can help you identify not only the sex acts that you most enjoy but also the situations which are most supportive of having intimate, exciting, and fulfilling sex. Use it to add in sexy things you enjoy and identify things in your control that block your pleasure.
Discover your current desires
Your body, desires, and what brings you pleasure is always changing. Try this sexy date night in to learn what your body wants now. You can do it solo or with a partner, whatever feels safer for you. The more you can acknowledge what’s true for you in this moment, even when the moment sucks, the easier it is to welcome in pleasure, joy, satisfaction, and connection.
Use pleasure tools
Vaginal dryness, pelvic pain, struggles to experience orgasm, and low desire are all sexual side effects from cancer and its treatments. Thankfully there are many tools that can support you. From vibrators to lingerie designed by and for breast cancer survivors to a yes/no/maybe list to explore your new desires, there are so many options to play and work with the body you have now.
Talk to your partner(s)
If you’re in a relationship, keep the lines of communication open. Share what you’re feeling, your fears, your desires and invite them to do the same. Make sure you and your beau(s) have additional support beyond each other, and consider working with a sex therapist. Many cancer centers have a social worker of similar who can support you. Remember they aren’t mind readers, and whether you’re horny all the time or don’t want to be touched, it helps when you’re both on the same page.
Cancer doesn’t have to mean the end of your sex life
If you’re craving pleasure, connection, and release, use these ideas as a jumping-off point to reconnect with your sensuality.