Sexuality and changes that occur in sexual desire are a large part of the ‘New You’ after breast cancer. It is thought that as many much as 70% of women treated for breast cancer have problems with their libido (sex drive) and sexuality after treatment. In some cases, sexual situations may bring up either physical or emotional pain. Just remember that this is normal, and that it might take some time to adapt to the New You. To help you better know about what changes are linked to breast cancer, this Tip starts with review of normal sexual response and follows with tips to think about and discuss with your spouse or partner.
Sexual response occurs in four phases:
- Desire, also known as libido, is the interest that one has in sex. Desire for another person begins the sexual response. Desire is influenced by sight, touch, thought, fantasy, and foreplay. Desire for sex can vary over time. Sexual desire may also be affected by emotional reasons like comfort with one’s sexuality and feeling attractive.
- Excitementor arousal occurs when the body reacts to stimulation by increasing the flow of blood to sexual organs. Heart rate and blood pressure increase. The vagina produces a natural lubricant that helps make intercourse comfortable. The vaginal walls also loosen and widen. Nipples become erect. Arousal may not necessarily lead to orgasm.
- Orgasm is the climax of pleasure where the body has a series of rhythmic contractions. It is physical release and an emotional high.
- Resolution follows sexual arousal and orgasm. Sexual activity generally results in a satisfied feeling and the body returns to normal.
Here are some tips to think about in discussing your sexuality concerns:
- Create a safe time and place to talk about your sexual concerns. Find a place where you can be alone and take your time. You and your partner may need to make time for talks about closeness. Talking about your concerns is needed and will open the door to talking about other matters. It may often be easier to talk outside the bedroom and not during sex.
- You may be the one to bring up the subject of sexuality. Your spouse or partner may not know what to say or fear that talking about it will be too painful for you. Talk about what means most to you – feelings about the changes in your body and fears of rejection. Ask and listen to what means most to your spouse or partner.
- Have a realistic outlook. Select one or two things to discuss rather than your entire list of concerns. Be clear in your talking.
- Think positive. Set your goals in a positive light. Remember that intimacy and sex are life-affirming activities.
- Keep in mind that your spouse or partner may worry about pain and how to touch you for fear of hurting you. Agree with your spouse or partner to let them know when and if any activity causes discomfort. That way your partner can proceed with confidence.
- Discuss any fears that you have about sexual rejection. Breast cancer and its treatment may have changed the way you look. It has also changed the way you function sexually. Be as honest as you can when you talk about these things.
- Be a good listener. At the end of your talk, go over you and your partner’s concerns.
- How you express your sexual feelings with your spouse or partner is important. Be patient and give yourself time. Being uncomfortable and anxious are normal feelings. Confidence and comfort should return in time.
- If you are having trouble with decreased sexual desire, talk to your doctor. There are ways they might be able to help you. (see the loss of libido resource:http://www.breastcancer.org/tips/intimacy/loss_of_libido)
When Do You Need to Seek Help?
You need to be able to talk openly with your spouse or partner. If you have continued difficulties in communicating, consider a referral to a professional counselor or support group that discusses these issues.
Living Beyond Breast Cancer: Ask the Experts- Sex and Intimacy
Young Survival Coalition. The Blow Below the Belt-Changes in Sexual Desire and Intimate Experiences
Breastcancer.org: Beyond Intercourse
Oncolink: Sexuality and Breast Cancer: Overview of issues
Loss of Libido (sex drive)