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Sex and Breast Cancer

Sex and Breast Cancer | Jo Divine

Receiving a diagnosis of breast cancer can be devastating and hard to digest. Thousands of women go through this ordeal every year with success, but the disease or effects of treatment can affect their sexuality and ability to return to satisfying sexual intercourse. Understanding what is happening to their bodies, simple changes to the way in which they see themselves and how they have sex can benefit the sex lives of women after breast cancer and help them to enjoy a fulfilling relationship and to make new relationships again.

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Recovering from breast cancer can leave many women feeling unattractive, suffering from low libido and experiencing decreased sexual satisfaction. Many women report sexual problems after completing their treatment, either as a result of the treatment or physical changes in their bodies. Any form of cancer can impact upon a person’s sexuality but it can be more problematic after breast cancer, because the breasts are intimately connected with sexual attractiveness and erotic play.

Some women feel uncomfortable being naked in front of their partner or feel discomfort when touched by their partner, either on the site of their surgery or in their genital area, often as a result of chemotherapy and drug therapy which can make these parts of the body sensitive or painful. However, this does not need to be a problem as there are many ways in which a woman can begin to feel sexy again with the right help and support from partners and medical professionals.

It is important to realise that getting back to sex after treatment is a gradual process and cannot be rushed. Taking your time and going at your own pace will ensure higher success at returning to normal sexual activity.

“Sex can feel like a work in progress during breast cancer treatment and beyond so take your time and have some fun too”

You may find it becomes more pleasureable as you explore different ways to enjoy sexual intimacy.

Communication

As in any relationship, this is the key to success between couples. The way in which you communicate with each other is important: often, one partner will highlight a problem or issue that the other partner has never considered or may consider to be trivial. It is not always easy to talk about sex, but finding the right environment for both of you is essential. You need to consider how you share sexual pleasure and what has changed within your relationship.

Explore new ways of sexual intimacy, such as sex without intercourse, using sex toys or bondage to explore each other’s bodies, read erotic fiction or watch films to increase arousal. Tell each other what feels good and what is uncomfortable or painful.

Physical changes to your body

Breasts play an important part during sex, especially if you enjoy having them stimulated. Losing a breast or changes to a breast through surgery and radiotherapy can impact upon the way you feel about being a woman and your sexual satisfaction. Your partner may be affected by the way in which you look if they gain sexual pleasure from the look or feel of your breasts.

Following surgery, your breast may feel more sensitive or may have areas of numbness. It can be helpful to your partner if you tell them where and how you would like to be touched, or even guide their hand so they know how to touch you and what pressure they can use.

If you do not like having your breasts touched, try other parts of your body such as neck, ears, lips, thighs and genitals for sexual stimulation. Try massaging each other with scented oils or take a long, hot bath, soaping each other all over. These simple techniques can help you to reconnect sexually.

The way you look

Being in a relationship or single, many women mourn the loss of their breast, others rejoice that it has gone with their cancer. Feeling self conscious about the way you look is common, but many people do not even realise that you have undergone a mastectomy. Confronting the physical changes to your body is important and will enable you to feel confident about how you look. For those in a relationship, involving your partner can help too.

Some women choose to wear a prosthesis in their bra prior to having reconstructive surgery. The choice of underwear for women who have had a mastectomy is wide and your breast care nurse can put you in contact with a specialist underwear advisor trained in helping you to find the most suitable lingerie. Many women have breast reconstruction soon after surgery and find it enhances their quality of life. Others choose to use prostheses and underwear.

RecoBra has been designed by Nicole de Havilland. She has worked within the breast cancer patient industry as a therapist for over twenty years. Nicole came up with the idea of a seamless recovery bra when her patients expressed disappointment that they could not find a suitable bra to wear immediately following breast surgery. Many bras are inappropriate and have seams which cause skin irritation and broken skin. Recobra addresses the specific needs of post operative recovery.

Choosing pretty lingerie can really help your self esteem and body image. There are several specialist lingerie websites, including Lovemeandmysecret that have gorgeous bras and matching knickers, especially for post mastectomy. There are several companies that offer great swimwear too. Cleverly designed, many feel comfortable to wear and look feminine too.

If you are used to wearing low cut tops, you may feel self conscious and wish to change the way in which you dress, but there are many great clothes which can still make you feel feminine. Breast reconstruction can enhance your figure and you may end up with better breasts that you used to have!

You can have your nipple tattooed onto your new breast or if it has been removed. Some women have their breasts tattooed with incredible designs which look amazing.

Weight gain

Gaining weight can often be a result of treatment, being less active or eating more when you feel anxious. This can lead to low self esteem, but changing your eating habits and taking regular exercise such as walking can help control weight gain, improve your overall sense of well-being and speed up your recovery.

If in a relationship, your partner may enjoy your new sexy curves, hopefully boosting your sex life, or they may encourage you in losing weight by joining you in your new exercise and diet regime.

New research published in Canadian Medical Association Journal (2017) highlights that physical activity and avoiding weight gain are the most important lifestyle choices that can reduce the risk of cancer recurrence.

Some NHS trusts offer a 6 week exercise programme after treatment to help you return to exercise in a safe way but this is not widely available across the UK.

Great Manchester Sport offer Fit After Cancer Treatment, a group designed to support cancer patients with physical, mental and emotional fitness once their treatment is complete.

Jo Taylor from ABC Diagnosis piloted the first Breast Cancer Retreat in Yorkshire which included Yoga, Walking/Nordic walking, Running, Cycling, Relaxation & possible therapies, and how to deal with menopause, all with trained professionals which received a great response.

Hair loss

Not everyone loses their hair when undergoing cancer treatment – it depends on what type of drugs are being used. Hair loss can be a distressing side effect of chemotherapy, but it is always temporary and hair usually grows back after treatment has stopped. Some people even find that their hair is thicker than before. Using a wig may help, and there are many companies who provide suitable wigs for people undergoing chemotherapy. If you find a wig uncomfortable, try wearing hats or scarves. Dying your hair is not recommended during cancer treatment but using vegetable dyes is suitable. Some women lose their eyebrows which can be distressing, but using make up or semi permanent make up can help.

Skincare

Cancer treatments can impact upon your skin, making it feel dry, itchy and sore. Jennifer Young created BeautydespiteCancer, a skincare range that specialise in skin care products designed for people who have had cancer to prevent irritation. They also offer great nail care products too as these often fall off or become brittle after treatment.

Great sex with intercourse

Gradually building up to penetrative sex can be fun. Try masturbating each other using your fingers, sex toys or with your tongue. If your vagina feels dry or painful, use a good quality lubricant such as YES organic lubricant to nourish the genital tissues and make the whole experience feel pleasurable.

Invest in a sex toy for yourself and your partner so you can both enjoy the pleasures of masturbation. Try a clitoral vibrator or male masturbator such as a Fleshlight.

If single or in a relationship, solo play is ideal for relaxing and helping you enjoy sexual pleasure, switching everything off around you and concentrating on all the gorgeous sensations coursing through your body. A bit of self love benefits everyone, reduces stress, decreases pain and can help you to enjoy a better night’s sleep too.

Loss of libido

Many women being treated for breast cancer find that their libido reduces or disappears completely as a result of their treatment, prolonged fatigue, physical changes to their body, lack of confidence about the way their body looks after surgery or constant worry and anxiety about their diagnosis, treatment and future. Take time to explore what works for you sexually and seek medical advice if you feel that the problem is not resolving itself. Many drugs for breast cancer can impact upon your libido and a simple change in your drug therapy may reduce any unpleasant side effects.

Menopausal symptoms

Many of the side effects of cancer treatments can bring about symptoms of the menopause which can be distressing. Hot flushes, night sweats and vaginal dryness can affect your sexual relationships.

Menopausal symptoms often affect younger women who have had breast cancer, making them mourn not only the loss of their breast but also their sexuality through changes to their sexual function. Counselling can help women find ways of dealing with this.

Infertility

The stress of having a cancer diagnosis, then undergoing surgery to remove your breast and cancer treatment is extremely stressful and this can impact upon your sex life.

Cancer doesn’t know your age and many younger women have breast cancer. For younger women, treatment may mean they are unable to have children or any more children, creating anxiety and stress. More advice is needed for younger women about their fertility and what options are available to them to preserve their fertility.

This is often overlooked or considered an afterthought when younger women have a cancer diagnosis but being unable to have children affects both your physical and mental health, which in turn, impacts upon recovery and quality of life post treatment.

A survey by Breast Cancer Care (2016) found that 53% of younger women were not given the chance to discuss the possible impact of their treatment on fertility despite national guidelines recommending younger women should be offered fertility preservation before starting breast cancer treatment.

A new Psycho-Oncology analysis of the published literature (2017) indicates that many cancer patients are not receiving support for fertility sparing choices or advice and recommends that all cancer patients of reproductive age should be provided with fertility information and referrals for fertility preservation. One of the reasons is that oncologists oncology may lack appropriate fertility knowledge and be unsure whose role it is to provide fertility support.

www.cancerandfertility.co.uk has been set up by Becki McGuinness who was left infertile by aggressive cancer treatment when she was just 23-years-old. Now 30, she’s launching a national campaign to ensure women facing cancer are given all the fertility options she should have been offered which would have preserved her fertility.

Discussing all your fertility options prior to treatment is important such as freezing your eggs or egg donation and your consultant or Oncology Nurse Specialist will be able to offer help and advice as to what you can do.

The Young Womens Breast Cancer Blog offers so much support for younger women going through breast cancer.

Vaginal dryness and irritation

Vaginal dryness and irritation leading to painful sexual intercourse is a common complaint in women who have had breast cancer. Using a good lubricant can help.

YES organic lubricants are odourless, tasteless and feel sensuous on the skin and don’t leave sticky residues behind.

They both offers nourishing qualities that are kind to the skin, rapidly relieving dryness and discomfort and is pH balanced to maintain good vaginal health.

Using an oil based lubricant first and applying a water based one on the top creates a double glide affect, which feels more comfortable and can help sex last longer. However, oil based lubricants are not condom compatible so stick to water based lubricant if you are using them.

YES also come in handy applicators making it easy to get the lubricant right inside your vagina.

Some people prefer a silicone lubricant which feel more slippery and can be used with condoms, making it a great alternative to oil based lubricants. Silicone lubricants should not be used with silicone sex toys as they can damage the material of the toy.

Work those PC muscles

Pelvic floor exercises can improve blood flow to the vagina and enable you to relax these muscles during sex and intimate pleasure to reduce pain. Using pelvic floor exercisers can help and involve little effort. Strong pelvic floor muscles can also increase the intensity of orgasms.

How to orgasm

Treatment for breast cancer can affect the way in which you experience orgasms. You may find it more difficult to orgasm as a result of your ability to become aroused due to tension and anxiety. Drug therapy can cause decreased sensation during sexual arousal, affecting how long it takes you to reach orgasm or the intensity.

Whether you are single or in a relationship, using sex toys can help increase sexual stimulation and help you achieve sexual pleasure in other ways through solo play and couples sex.

Many sex toys help women to relax and can create a different sexual experience. Getting your partner to use a sex toy on you can help you to connect, even when penetrative sex is not possible.

When penetrative sex is possible, incorporating the use of sex toys on your clitoris can help increase your sexual pleasure and hopefully produce an orgasm.

For same sex couples, take it slowly with sex toys for penetration if you find it painful, perhaps switching to a slim product, rather than your regular go to sex toy.

Pain, numbness or sensitivity during sex

Pain from scar tissue will slowly resolve following surgery and teaching your partner to be gentle with you can help, guiding them where to touch you and what pressure to use. Many partners feel anxious about touching their partners for fear of causing pain and will be more than happy to be told what feels good and where to avoid.

Take pain medication before having sex to help ease any discomfort. Try experimenting with different sex positions if it feels uncomfortable – using pillows can help support you. This can be great fun as you explore what works for you. Lying side by side in a spooning position feels very intimate and will place less pressure on your body, as will being on top.

Using a small sex toy during sex can help you both achieve sexual pleasure. A vibrating cock ring such as the OMB Share can bring pleasure to both you and your partner if worn when you are on top. The vibrations will stimulate both your clitoris and their penis at the same time, ideal if reduced sensation is a problem.

Fatigue

Fatigue is a common side effect of chemotherapy and radiotherapy. The key is to take things at your own pace: you can take a less active role during sex. Taking it slowly may increase your sexual arousal more, and by exploring new sexual techniques you may discover areas of sexual pleasure you have never experienced before.

If you feel physically drained in the evening, try having morning sex or sex during the day. Even quickie sex can be fun and may reduce your fatigue. By slowly increasing the amount of physical activity you do, you may have more energy for sex.

Lymphoedema

Lymphoedema is swelling of the arm, hand or breast due to a build up of lymphatic fluid in the tissues. It is a long term condition which can be controlled by medication. If you feel uncomfortable, try different sexual positions. Take your medication before hand to give it time to work. Talk to your partner about how you feel and guide them to touch you in a way which causes the least discomfort.

Seek advice from a specialist physiotherapist who is trained in lymphatic drainage which can ease pain and discomfort.

Muscle tightness and cording

Known as cording, some women develop scar tissue in the armpit which forms a tight band. Usually this can occur around 6-8 weeks post operatively. Although harmless, cording feels similar to a guitar string and can be uncomfortable.

A specialist physiotherapist can teach you how to massage the area to help increase the movement in your arms and shoulders.

Your partner

Often, the feelings of the partner are neglected in our haste to reassure the women with breast cancer, but the disease affects both her partner and her family. Some partners embrace what is happening and fully support their loved one, whilst others struggle to cope with their feelings about what is going on. Accepting what has happened and involving your partner can help them to understand what is happening and enable them to support you.

They may take on the role as protector to shield you from further harm, which could make your relationship feel claustrophobic and lead to conflict. They may not want to have sex because they are anxious about hurting you. As mentioned above, good communication can help allay any negative feelings either of you are having about sex and your relationship.

It may be helpful to seek help from counsellors or speak to the breast cancer care nurse. Finding new ways to enjoy sex can be fun but sometimes daunting, especially if you do not feel comfortable talking about sex.

A new relationship

Looking for or starting a new relationship can be difficult and you may feel anxious about becoming intimate. Meeting someone new, you may find it difficult to tell them your experience but most people understand. If they struggle with this, perhaps they aren’t the right one for you.

As you get to know your new partner, you will feel more comfortable and you may find it easier to broach the subject. They may be initially shocked at your news and it could take time for them to adjust to the situation. On the other hand, they may be very accepting of your history and the way you look. They may also have experienced something similar in their past, so will offer support.

Many women return to having a normal sex life after undergoing treatment for breast cancer but some women still experience sexual problems. Making changes to the way in which you view your body and how you have sex can help. If you continue to have sexual problems, it is important to seek help from a suitable healthcare professional who may recommend counselling or couples’ therapy.

At Jo Divine we believe that sexual health and sexual pleasure go hand in hand and have created a health brochure with suitable products to help people with sexual issues. Working with medical professionals, we hope to encourage patients and HCPs alike in talking more freely about sexual problems. A health issue doesn’t mean your sex life will have to stop!

Breast Cancer and Men

Breast cancer doesn’t just affect women but men too. They also experience many of the psychological and physical symptoms and side effects from treatment and surgery that women do. There are about 350 men diagnosed each year in the UK, compared with around 50,000 cases of breast cancer in women. The symptoms, diagnosis and treatment are all very similar to women with breast cancer. but it isn’t often talked about and many men struggle to get the same support than women do.

Male Breast Cancer coalition offer help, support and advice to men who have or have had breast cancer and their families : malebreastcancercoalition.org

Macmillan also have a booklet – Understanding breast cancer in men

Helpful blogs

There are some amazing women blogging about their experience of breast cancer and these are just 2 of my favourites who offer practical advice to the many women who have breast cancer.

The fabulous Jo Taylor : www.abcdiagnosis.co.uk
Dr Elizabeth O’Riordan and Woman of the Year : www.liz.oriordan.co.uk

Helpful Reading

Dr Kathleen Thompson has documented her journey through having breast cancer in her book, offering advice, tips which can help so many other women negotiate the changes to their life both physically and mentally that having a diagnosis of breast cancer can bring. She has written about the do’s and don’ts of her treatment, things that she wished she had said or done, things she did say and do and how she became an expert, as do so many people when they have a cancer diagnosis.

A brilliant read for women with breast cancer and their families and friends.

From Both Ends of the Stethoscope: Getting through breast cancer-by a doctor who knows- Dr Kathleen Thompson, published by Faito Books (4 Jan. 2016) available on kindle and in paperback

Useful Websites

Breast Cancer Care : www.breastcancercare.org.uk
Breast Cancer Chat WorldWide : @bccww
Young Womens Breast Cancer blogspot : www.youngwomensbreastcancerblog.blogspot.co.uk
Pink Ribbon Foundation : www.pinkribbonfoundation.org.uk
Prevent Breast Cancer :www.preventbreastcancer.org.uk
Asian Breast Cancer : www.bmecancer.com
The Daisy Network :www.daisynetwork.org.uk
The Dovecote:www.thedovecote.org
Fertility and Cancer : www.cancerandfertility.co.uk
College of Sex and Relationship Therapists : www.cosrt.org.uk
Jennifer Young : www.beautydespitecancer.co.uk
RecoBra : www.recoheart.com/recobra-story
LoveMeAndMySecret :www.lovemeandmysecret.com

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