Fatigue and Sexuality

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Fatigue is the most common side effect of breast cancer treatment. It’s that low-energy, tired-all-the-time feeling. As many as 9 out of 10 people experience fatigue at some point during treatment. What causes fatigue when you are receiving treatment for a diagnosis of metastatic breast cancer?

  • Surgery can disrupt your body’s normal rhythm, causing fatigue that lasts longer than you may expect. General anesthesia and after-surgery discomfort, pain medication, and restricted activity can also cause fatigue.
  • Chemotherapy may reduce the number of red blood cells (the cells that deliver oxygen from your lungs to your cells), immune cells, and platelets (clotting cells) produced by your bone marrow. Chemotherapy medicines also can damage some cells or limit their ability to function. Low blood cell counts can contribute to fatigue. If you have a low red blood cell count, for example, a condition called anemia, you'll probably have less energy. If your immune cell count is low, your body has to work harder to fight off infections. Infections and fever can lead to fatigue. Chemotherapy also may cause early menopause for some women. This changes the balance of hormones in your body and can lead to fatigue.
  • Radiation can often lead to fatigue. When you're getting radiation, you may be feeling weak from earlier surgery or chemotherapy. Radiation therapy to a large area of bone can lower your red blood cell and immune cell counts, which can contribute to fatigue. Plus, the daily demands and schedule changes that come with radiation therapy be tiring.
  • Hormonal therapy reduces the amount of estrogen in your body, as if you were going through menopause. This can make you feel tired and weak. Many premenopausal women have menopausal side effects while taking hormonal therapy, such as hot flashes, which can disrupt sleep and lead to fatigue.

Fatigue may be a normal part of treatment for metastatic breast cancer, but it can also impact your sex life and your intimate relationships. Try these ideas to regain some energy:

  • Exercise. Although it may sound counterintuitive to exercise when you are tired, exercise, with your physician’s guidance, helps reduce fatigue both during and after treatment for a cancer diagnosis.
  • Seek out a therapist. A study showed that psychological interventions, including cognitive behavioral therapy (CBT), can help lessen cancer-related fatigue both during and after treatment. These approaches can help you identify, understand, and then change any negative thoughts you’re having, which in turn may free up some of your energy. To find a certified psychologist or therapist in your area, visit the American Psychological Association website.
  • Take power naps. A short nap can refresh and revive you. Just be sure not to nap too often or too close to bedtime so it does not affect your overnight sleep quality.
  • Revamp your diet. The food you consume can impact your energy level. Eating cleanly and consuming ingredients you know and can pronounce is important for everyone. Assess your diet and make changes with your physician’s guidance, and read up on nutrition tips and resources.
    • Choose foods that provide sustained energy. Complex carbohydrates such as whole grains, legumes, and vegetables release energy slowly. Simple carbohydrates, on the other hand, such as sugar, white flours, and fruit juices, can cause your energy to quickly spike and then drop.
    • Choose snacks that give you the biggest nutritional boost. A candy bar and a green smoothie, for example, can have roughly the same number of calories. But the green smoothie, besides being creamy and sweet, will likely keep you full longer because it contains the fiber of vegetables and fruits. The smoothie will also supply you with important vitamins and minerals and give you a healthy dose of nourishing phytochemicals. The candy bar, on the other hand, is mostly empty calories -- you are getting little nutrition for the calories you are consuming.
    • Stay hydrated. Dehydration can make fatigue worse. Be sure to drink plenty of water or herbal teas throughout the day.
  • Try complementary practices. Complementary techniques, including yoga, meditation, acupuncture, acupressure, and massage, may sound like an indulgence. But they have numerous health benefits, including reducing fatigue and stress and promoting relaxation. So go ahead, indulge!

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