Sex, intimacy and breast cancer

A survey by Breast Cancer Now revealed that nearly 46% of women who were diagnosed with breast cancer experienced some form of sexual difficulties - from loss of libido to vaginal dryness - and that three quarters of women asked were not told about the possible impact of treatments on sex and intimacy.

Here Kate Harrison, Consultant Psychologist at The Christie Private Care, part of HCA Healthcare UK, discusses the impact that breast cancer and its treatment can have on sex, relationships and intimacy, and some of the ways that you and your partner can navigate these.

Reflecting on how you feel

When diagnosed with breast cancer, it’s normal to be focused on hitting key treatment milestones and getting well again. However, once you have got through these stages; you may start to reflect on your relationships and how these might have changed, particularly the relationship with your own body, and with your partner. While these changes can be positive, you may also find that you’re not comfortable sharing your body, your libido may be low, or you may experience physical symptoms such as vaginal dryness that can take away from intimacy as well as sexual pleasure and your desire to have sex.

You may feel guilty for feeling this way; “I should be grateful I’m alive, how can I ask for more?” But it’s so important that you don’t dismiss how you’re feeling, if you do want more, you absolutely should ask for more.

It's important to know you’re not alone if you’re having problems with sex, relationships and intimacy during or after treatment. Nearly a third of women surveyed by Breast Cancer Now said that they had experienced loss of libido as a result of their diagnosis, and 66% who had experienced sexual difficulties said that it had a negative impact on their general wellbeing. It's a common problem associated with cancer treatment, but not necessarily something that is always openly discussed between partners or with medical professionals.

How treatment can impact your mind and body

Everyone responds differently to breast cancer treatment. You may experience hormonal changes following treatment, which can affect how the vagina works and cause thinning of the vaginal walls and loss of vaginal lubrication. You may have had a mastectomy and lost some sensation or feeling in one or both breasts. As well as these physically identifiable, tangible changes, cancer and cancer treatment can also have a psychological impact. You may find that you don’t want to be intimate with your partner, your body image and confidence may be affected, so you may not feel as sexually attractive as you once did, or you may find it difficult to become aroused or reach orgasm.

It's so important to seek help and advice if you identify with any of these thoughts and feelings and feel able to share them. Ignoring them can negatively impact your own psychological wellbeing and your relationship with your partner or future relationships. 

Reintroducing intimacy with a partner after treatment

When being intimate or reintroducing intimacy, it’s important to go slowly and at a pace which suits you.

The key thing to remember is that it’s not all about sex. It's about introducing closeness, intimacy and communication, and both of you being comfortable in your own skin and with each other. Some tips I would suggest include:

• Take time for yourself to feel comfortable in your own body. Have a bubble bath and try to feel relaxed in your own skin before trying to progress things with your partner
• Introduce closeness with your partner. Perhaps you could give each other massages to reintroduce the element of touch 
• Cook food together and light some candles to bring the romantic element back
• If you feel ready, explore other sexual activity that doesn’t involve full intercourse and see how that feels

You may attempt these steps but still not feel comfortable. It's important not to push yourself into doing anything – but try to regularly communicate how you’re feeling to your partner.

What if I don’t have a partner right now?

If you were single during your diagnosis and treatment, you might be worried about dating someone new. You may be worried about how having breast cancer might affect future relationships.

Some people find it difficult telling a new partner about their breast cancer journey, but remember, you are in control of when and how you choose to tell someone, and only do so when you feel comfortable.

Whether you’re single or in a relationship post breast cancer treatment, you deserve to live a happy, healthy and fulfilled life. So, if you are struggling with concerns regarding intimacy, sex or relationships, it’s important you share your concerns. Talk to a medical professional or talk with a loved one – just don’t keep things bottled up.

More about living with and beyond breast cancer