Sex After Breast Cancer: One Survivor's Experience

When I was diagnosed with breast cancer, the furthest thing from my mind was sex. I didn’t give a thought to what losing my breasts would do to my sex life or how it would impact me in that area. My focus was on getting through surgery and treatment. I was in survival mode. My husband and I did not discuss anything related to sex. It wasn’t a priority.

After surgery, my body was weak and sore. Along with both breasts, I’d had several lymph nodes removed. Healing took months. As soon as I’d recovered from surgery, I was thrown into treatment which caused me to experience major fatigue and many emotional changes. My husband was patient and understanding during that time, never demanding to have sexual relations with me. Although we didn’t discuss the impact of breast cancer on our sexual intimacy, it was very significant.

Although most women who experience breast cancer may not be aware of the fact, difficulties with sex after cancer are very common. For the unaffected spouse, fear of hurting their partner during sexual activity prevent them from pursuing intimacy. They may feel guilty for wanting to impose their needs upon their partner so they forego sexual relations. This lack of interest can be perceived as rejection for the woman who’s been through cancer. It can be overwhelming to go through the trauma of breast cancer and then face the loss of a physical relationship with a partner.

In our culture, breasts are perceived as being sexual. Men are wired to be visual creatures and for many men, breasts are a sexual turn on. When men see exposed breasts, they often become aroused. In a marriage, this is normal and acceptable. But what happens when the breasts are gone? Breasts are one of the most sensitive erogenous zones for many women. The nipple, once stimulated, can excite sexual arousal. For women who’ve had one or both breasts removed, this creates a challenge. Some women feel their breasts are a major part of their sexual identity. I was one of those people.

Radiation made my breasts become red and sore. They were very painful to touch. My mastectomy scars were uncomfortable and hypersensitive. My chest area remained numb for months and months. When I had both of my breasts removed, I was surprised at how quickly my body image and self-esteem lowered. I felt there was something wrong with me. I felt I was deficient. I not only expected rejection from my husband, I created it. I declared myself unattractive and unworthy of love. I radiated despair and withdrew emotionally from his attempts to show me affection. I withdrew from any sexual advances and had no desire to experience intimacy again. I assumed this was par for the course, an after effect of breast cancer. I would just have to accept this new normal. I was very self-conscious and did not want my husband to see me without clothes. I often went into another room to undress just so he wouldn’t see me. I didn’t realize it at the time, but I felt I had nothing to offer. My breasts had been my femininity. Now they were gone.

My husband very gentle and sensitive toward me. As we both learned to accept the changes in my body, neither of us focused on sex. We found it OK not to have sexual relations. We’d been married long enough that we knew each other well. We respected each other. For months and months, we barely touched. We still loved each other. We still cared about each other, but it was different. When I confronted him about his lack of interest in me, he was shocked. I told him I felt rejected. He explained he had avoided making any physical demands on me for fear of physically hurting me. We cried for each other’s private pain but were glad to have it finally out in the open.

Without physical touch, I felt unloved. I began to spiral into an emotional depression. We were struggling. Neither of us knew how to survive this situation. No one in our family had dealt with breast cancer. It was foreign and new to us. We faced many difficult days and often found ourselves angry, frustrated or in tears. During that time, my husband turned to internet pornography to have his needs met. This discovery almost dissolved our marriage. I didn’t know how much more I could take. Cancer had stolen my breasts, almost decimated my marriage, and had caused my husband to be alienated from me. I knew we needed counseling but neither of us felt the freedom to ask for help. After confronting my husband about his new vice and sharing my heartbreak and hurt over it, we finally reconciled. I talked to him candidly and helped him see his decision to do this was not only disrespectful toward me but screamed I was no longer desirable in his eyes. I’m not sure he completely understood my pain but he listened and agreed to end his addiction. We both agreed to try to regain our physical intimacy and sexual relationship.

Our first few attempts at sexual intercourse failed. He could not get aroused and I felt even more unlovely than ever before. Without my breasts, I found other parts of my body were very sensitive to touch. Having had bilateral mastectomies, all of the nerve endings in my chest area were numb but my back was extremely sensitive. I assumed this would be a new erogenous zone and shared the information with my husband but we both ended up being disappointed.

Months went by with no physical touch other than an occasional hug. Due to insomnia and painful lymphedema, I began to sleep in another room. My husband never complained or asked me to return to our bedroom. He seemed perfectly fine with the arrangement. I slept alone for a couple of weeks and then decided to return to our room. I did my best to initiate physical intimacy. I moved close and tried cuddling. He rolled over and went to sleep. I tried touching him but nothing seemed to work. The rejection returned.

It’s been six months now since we’ve been intimate. I’ve given up hope and have resigned myself to a life of celibacy. My husband seems content and doesn’t make advances toward me. Sometimes I worry he’s involved in internet pornography again, but I hope that’s not the case.

If I’d known things were going to be this difficult after surgery, I may have elected not to have had surgery.

I feel a little betrayed by my doctors. None of them offered advice or counseling in this area before or after surgery. Of course, my husband and I are partly to blame. We could have and probably should have asked for help, but we didn’t.

If I could give some advice to the medical professionals, I would suggest they make sure all aspects of life after cancer are discussed. They need to be sensitive and listen carefully to the concerns of their patients. The woman about to experience surgery or treatment needs to know how cancer might impact her marriage or partnership. Not all women will experience the same types of devastating events I’ve experienced, but they probably will experience some form of change to their sexual relationship. It would have been nice to have been prepared for this type of challenge in advance.

Advice I’d give to women who’ve been through surgery or treatment —

1. Understand your going to experience many emotional and physical changes.
2. Learning to accept your new body image may be difficult.
3. Chemotherapy or radiation may cause unpleasant side effects that will directly affect the physical relationship with your partner. Cancer can cause physical problems such as vaginal dryness, hot flashes, weight gain, depression and a decreased sex drive. Discuss any problems with your doctor and ask for help. You may want to ask your doctor for a prescription vaginal lubricant or hormone cream to help with dryness. It may be necessary to try an anti-depressant for a period of time.
4. Your sexual relationship with your spouse or partner may change. It’s important to have a game plan before you need it. You may need to get creative in the bedroom. Routines may need tweaking because the old way of doing things doesn’t work any longer. Unrealistic expectations that things will just pick back up where they left off aren’t always true, especially as they relate to sexual intimacy.
5. It might be best to avoid sexual intimacy immediately after surgery and for a time short time longer. Waiting until your body has healed will give both you and your partner time to accept and understand changes to your body. When you are ready, take things slowly. Being anxious the first time intimacy is attempted after breast cancer surgery is natural. It’s difficult to know what to expect. Share your feelings and concerns with your partner. Talk openly and honestly. Take things one small step at a time. Be patient and remember to love yourself.

I continue to have hope for my marriage. I love my husband dearly and want to be intimate with him. I know he still loves me too, because he tells me this every day. The challenge of conquering sexual intimacy issues related to cancer persist but with patience and love, we’ll hopefully find a way to express our love once again.

It was extremely difficult to share this deeply personal part of my cancer experience. I’ve asked the magazine editor to keep my identity private because of the sensitivity of this article. My intention in sharing my personal story has been to help or encourage someone who may be going through their own difficult time with sexual intimacy now. As a cancer survivor, I’ve found it always helps to know I’m not alone in the things I experience and I’m sure others feel the same way, too.