Between surgery, chemotherapy, radiation, stress, fear and exhaustion, sex may be the last thing on your mind. In fact, you may even be wondering if you'll ever feel desire again.
It's a huge problem, with studies finding that 60% to 70% of women who have had breast cancer experience treatment-related sexual problems. The cause could be surgery, chemotherapy, radiation and other therapies. But unlike the nausea, hair loss, fatigue and other side effects of cancer treatment, sexual problems may not go away when the treatment ends.
You might be left with vaginal dryness from the lack of estrogen, dealing with body image problems after a lumpectomy or mastectomy, experiencing hot flashes (and the resulting sleeplessness) from early menopause, or simply feeling too exhausted to even think about sex.
Unfortunately, many breast cancer survivors with sexual health concerns suffer in silence, and their issues go unaddressed. This can have a profound impact on quality of life.
Sex isn't just about intercourse. It's also about intimacy and closeness, touching, holding, kissing, cuddling and massage. These are all important components in a healthy relationship, and something you probably need now more than ever. Intimacy can also eventually lead to sex — or not. It's vital to be honest with your partner about where you are in the journey and for both of you to be willing to travel on that journey together.
It's also important to talk to your healthcare provider (HCP). Don't wait for them to bring up sexual health concerns. As difficult as it may be, you must bring up the topic to ensure that you learn about available treatments. There are many therapies available including sex therapy, pelvic floor physical therapy, dilators, moisturizers and lubricants, prescription therapies and laser therapy.
If you find your HCP is unable to adequately address your concerns, ask for a referral. If body image is playing a role in your problem, a good therapist can help you feel more accepting of your body, as well as talk through any issues related to desire and intimacy. There is help available, and you do not need to suffer in silence.
Fertility after breast cancer
Although most women are diagnosed with breast cancer after menopause, between 6% and 10% of women are diagnosed at age 44 or younger, and many of them still want children. Yet cancer treatments such as chemotherapy and radiation can affect fertility, even sending women into early menopause.
Thankfully, there are several options to help protect or preserve fertility. These include freezing your eggs before treatment begins, using drugs that may help protect the ovaries (although the evidence is mixed), and undergoing in vitro fertilization and freezing the resulting embryos before you start your cancer treatment.
Since your surgeon or oncologist is focused on treating your cancer, future fertility may not be something they will think to discuss with you. It's important that you broach the subject and express your concerns. Your HCP should be able to refer you to a specialist who can explain your options and help with this difficult decision.
This resource was created with support from Merck, Daiichi Sankyo and Sanofi Genzyme.