Intimacy After Breast Cancer

Many people have trouble understanding concepts related to intimacy, but when there is illness some basic ideas become even more important to understand.

One of the most important concepts that is often misunderstood is a woman’s sexual response. A woman may feel a tremendous amount of shame if she doesn’t feel overcome with desire prior to sex. Many people believe that women should possess a biological hunger and physical drive for sex and may consider those who don’t “dysfunctional.” However, sexual response can play out in many ways for women. Often women are motivated to be intimate from an intellectual space and want to connect to and be close with their partner. Many times they will initially engage with a neutral feeling, rather than because of a physical urge. In the process, however, most women will start to experience arousal (blood flow to and lubrication of the vaginal area). Unlike what you may see in the movies, which often show women feeling biological desire first and then bursting into orgasm, frequently a woman experiences desire (sexual thoughts and fantasy) after she engages.

Some people may feel as though someone with a serious medical diagnosis should be grateful for making it through treatment. The may ask, Why even talk about sex at a time like this? People buy into the cultural bias that someone with an illness is no longer a sexual person. Little time is spent in medical offices examining what can be done for sexual dysfunction. Keep in mind that people with illness don’t stop being sexual people when they are diagnosed. In Sex Matters for Women, Foley and her coauthors point out that the need for human intimacy and connection is not frivolous. Sexual health is a quality-of-life issue. It is a part of healthy living and it helps the healing process. Unequivocally, nothing is sexier than a focused woman who claims that sensual space as her own. However, if you find yourself avoiding touch or permitting touch when you don’t want it, it may be time to delay interactions with a partner until you feel ready, or proactively prepare yourself with a psychotherapist who specializes in sexual health. Know that while the timing must make sense, it may never be perfect.

Many couples make the mistake of thinking sex is intercourse. Couples who maintain intimacy throughout the treatment process know they can engage in other sensual ways. Consider a menu of possibilities that includes vaginal penetration on some nights, or genital touch or oral stimulation on others, not just as a precursor, but rather to offer variety to end-all, be-all intercourse.

Keep in mind that chemotherapy is an anticholinergic medication that can decrease lubrication and blood flow to the vaginal area. It can impact your sexual response, at least temporarily. When engaging with a partner, using the right lubricant is critical. Silicone lubricants are your best choice if you have been through chemotherapy or menopause.

You should also be aware that if you are having any pain with sex, it is best to discuss this with your doctor and consider calling a therapist certified by the  American Association of Sexual Educators, Counselors and Therapists (AASECT) to assist you with a plan to successfully integrate intimacy back into your life.


References

Foley S, Kope S, Sugrue D. Sex Matters for Women, Second Edition: A Complete Guide to Taking Care of Your Sexual Self. 2nd Edition. New York, NY: Guilford Press; 2012.