The most uncomfortable stuff to talk about is probably your sex life and the changes that have taken place with your illness. You may not know what needs fixing or how to fix it, but you know things are different.
Many women report having less sex than before their illness, for several reasons:
- The breast cancer experience slows down your body. It takes longer to do lots of things, including getting interested in and starting and finishing sexual intercourse.
- Sex may be uncomfortable or even painful if you've been thrown into sudden-onset menopause. No surprise that you tend to have less sex, for now. Many women may have had little or no sex from the time of diagnosis through treatment.
Most people have wild ideas about what goes on in other people's bedrooms. Give yourself a break: The carefully researched book Sex in America (by Michael, Gagnon, Laumann, and Kolata) tells us that Americans have a lot less sex than the movies, television, and the guys in the locker room would have you believe. The averages reported in that book are:
- seven times a month between ages 30 and 40
- six times a month between ages 40 and 50
- five times a month between ages 50 and 60
For people over 60, the numbers continue to decline. But although you may assume that no one in their 70s and 80s has a sex life, that's just not so.
Molly, 78, described her sex life after breast cancer treatment: "I stopped the action for a while, and then we went back at my request. He was waiting for me to give him the go-ahead." Hilda, an 82-year-old breast cancer survivor, explained that she didn't have a lover "at the moment." Sex goes on even into the 90s for some. And now with Viagra, who knows what new limits will be set?
Don't let the myths about other people's sex lives get in the way of what's happening in yours. And remember that there are exceptions to every pattern.
If your sex life is not working the way you want it to, your doctor or nurse may be able to referee these issues with your partner and you. You can cue your doctor in advance, since he or she has most likely already touched on delicate issues with you. Maybe he or she can be the tour guide for the two of you. If your partner is there when you talk with the doctor who's managing your care, you and your partner both get a chance to air and dispel fears, and replace myths and false information with facts.
Help from a pro
Not all doctors and nurses are comfortable discussing sexual issues and practices. Most doctors don't routinely ask about your sex life. And patients don't usually begin to discuss their love life with a doctor who hasn't mentioned it. Nobody's talking!
Someone has to break the pattern. A trained social worker, sex therapist, psychologist, or psychiatrist can help you open up communication with your partner and get around to talking about intimacy and sex issues.
A support group may be more helpful than you might realize. Women in these groups often share advice that extends to the bedroom, including ways to increase sexual pleasure that are explicit and specific for women who've had breast cancer.
Meeting needs in other ways
Most marriages have problems that don't get fixed. Marriage is a package deal, and in marriages that work, the good things outweigh the bad. But as a survivor, you may find that breast cancer highlights the problems in your marriage. Can you live with those problems? Can you enjoy your marriage even as you contemplate what's missing? Can you capture the missing pieces in other ways? Give serious thought to your needs and how to meet them.
Other ways to meet your needs:
- Fantasy can enrich your life. Countless women read to fill the vacuum (romance novels are enormously popular).
- Join a book club, a church or synagogue, or a group that meets to discuss investments, movies, or local politics.
- Do more with individual friends, like walking, shopping ("retail therapy"), or travel.
- Make a bigger deal of birthdays and anniversaries.
- Expand your involvement in community or spiritual activities.
- Get politically active in the breast cancer movement: camaraderie for a cause close to your heart.
Expert QuoteOne of my patients had told me that her breasts had been a crucial part of her sexual life before the discovery of her disease. She had breast cancer in both breasts, treated with l lumpectomy and radiation. Her breasts looked great—but her husband was ignoring them completely. I scheduled an appointment that included her husband and was able to reassure him that her breasts would not be harmed by fondling, kissing, or whatever; that he could not catch cancer; and that she was not radioactive. They quickly resumed their former lovemaking habits.
Robin M. Ciocca, D.O.