Sexual Health During and After Breast Cancer
Breast cancer can affect your sex life because of physical changes and side effects from the disease and its treatment. It’s also common for your mood and overall emotional and mental health to affect the way you feel about your body. If you have lost interest in sex and your desire to have sex, you’re not alone.
People’s sexual health may be negatively affected after a breast cancer diagnosis for a number of reasons, including:
exhaustion, both physical and mental, from their breast cancer diagnosis
loss of libido (sexual desire) caused by certain breast cancer treatment side effects, such as nausea and fatigue, or because of depression
discomfort or pain during, or immediately after, sex — particularly if breast cancer treatments, such as chemotherapy, trigger early menopause
negative body image after certain breast cancer treatments, including breast surgery, chemotherapy, and radiation
Whether or not you’re ready to have sex again, you don’t have to wait to manage some of the symptoms that might be affecting you now. Keep reading to learn about some of the more common challenges you might face, as well as how you can start to feel comfortable in your own body again.
Loss of libido
Libido is a term that refers to your desire to have sex — your sex drive. There are a variety of reasons that breast cancer might lead to decreased libido. After a breast cancer diagnosis, as you focus on getting better and managing the disease and the side effects from its treatment, sex may just be the last thing on your mind.
Other factors that can lead to loss of libido include:
experiencing anxiety, fear, stress, or exhaustion immediately after receiving a breast cancer diagnosis
having side effects (such as depression, lymphedema, and menopausal symptoms) from undergoing breast cancer treatments
taking certain pain medicines
taking tamoxifen, a hormonal therapy
Overall, it’s important to be patient with yourself. When you are ready, and only then, speak to someone on your cancer care team or a sexual health specialist to learn ways of managing your loss of libido. Together, they may be able to:
advise whether it’s possible to adjust certain medicines
recommend treatments for symptoms — such as depression or fatigue — that contribute to a lower libido
Learn more about loss of libido.
Vaginal dryness and painful sex
Some breast cancer treatments, such as chemotherapy and hormonal therapies, can lead to:
early menopause, which can also lead to vaginal dryness
pain or discomfort during sex, also usually related to vaginal dryness
Sexual health specialists who work with people diagnosed with cancer recommend using vaginal moisturizers as part of your regular self-care routine. Moisturizers last longer than lubricants, provide long-term relief from itchiness and irritation, and can help the vaginal tissue stay more flexible, which makes it less likely to tear.
Sexual health specialists also recommend trying different positions and doing targeted physical therapy, such as pelvic floor exercises.
Sexual Side Effects of Breast Cancer Treatment
Sep 17, 2020Sex during chemotherapy treatment
You don’t necessarily need to give up sex or intimacy while you’re receiving chemotherapy, targeted therapy, or immunotherapy if you don’t want to. But it’s smart to take a few precautions. For example, if it’s possible for you to become pregnant, doctors recommend using non-hormonal forms of birth control to prevent pregnancy during treatment. That’s because chemotherapy, targeted therapy, or immunotherapy may cause birth defects in a fetus, and may also increase the risk of miscarriage. Also, if you have a weakened immune system from treatment, it’s important to protect yourself from sexually transmitted infections.
Read more about sex and chemotherapy.
Changes in your appearance after breast cancer treatments
Both breast cancer and breast cancer treatments may cause changes in your physical appearance, including:
losing one or both breasts (mastectomy)
surgical scars
weight gain or loss
hair loss
Physical changes like these often lead to body-image issues that may cause some people to feel self-conscious, making it difficult to enjoy sex. In addition to issues with body image, breast surgery and other breast cancer treatments can cause pain in your breasts and other parts of your body, all of which might make sex physically uncomfortable or not as pleasurable.
The good news is that there are treatments and resources available to help you regain your confidence and ultimately restore your sexual health. It’s almost always helpful to speak to a therapist or counselor, especially if you have lingering body-image issues that are affecting your self-esteem. To help you manage any pain or discomfort, a sexual health specialist may recommend different positions, vaginal moisturizers, or other tips.
Mood and emotional changes after breast cancer treatments
After a breast cancer diagnosis, it’s not unusual for people’s moods, emotions, and mental health to change. Some people might have symptoms of depression or feel sad, anxious, or overwhelmed. These feelings can subside after a few weeks or months, or they can linger for several months to years. Such feelings, whether someone has them for the long or short term, can zap their desire to have sex.
Your cancer care team is in the best position to recommend mental health support for you so you can start to feel more like yourself again.
Learn more about taking care of your mental health after a breast cancer diagnosis.
Five ways to take care of your sexual health
Remember that you’re not alone. Many people experience a loss of sexual desire for physical or emotional reasons (or both) for months after breast cancer treatment ends. Your quality of life is essential, so the bottom line is that if you are worried about the loss of libido or sex that isn’t pleasurable because of pain or discomfort, there are specialists who can give you the support and help you need. Talking to someone on your cancer care team is usually a good place to start.
Not everybody feels comfortable talking about sex, so it’s important to know that oncologists and other members of your cancer care team might not bring up the topic of sexual health. Their focus, especially immediately after a breast cancer diagnosis, is on developing treatment plans to eliminate the cancer. So you may need to start the conversation. It’s easiest to do that with someone you trust on your cancer care team, such as your oncologist, nurse, or social worker. Any one of them can help either identify the cause of any sexual challenges you might be having or recommend mental and sexual health specialists who can help.
You might find that, in addition to talking with a doctor or specialist, it’s helpful to talk to a friend or family member about how you’ve been feeling. Remember that you can share as much or as little detail as you feel comfortable sharing. Sometimes talking with someone close to you, even if it’s not to get advice, can help relieve some pressure and stress.
For some people in monogamous relationships, it may be more comfortable to talk with their partners about sex, how their feelings about sex and intimacy have changed, and what they want and need. Although it’s certainly not mandatory, sometimes it can help to have some of these discussions with a couples therapist — preferably one who has experience working with people diagnosed with cancer.
Get tips on how you might prepare to talk with your partner about sex and intimacy after breast cancer.
Talking to other people who are going through similar situations as you could also be helpful. Today, both in-person and virtual support groups are readily available. At Breastcancer.org, we offer online support via our discussion boards and virtual community meetups.
Exercise stimulates the production of endorphins, which contribute to your sense of well-being and can boost your mood. It can help alleviate other breast cancer and breast cancer treatment side effects and make you feel more comfortable in your body, too. Exercise also can improve sexual arousal and indirectly enhance sexual satisfaction by improving your heart health and mood.
Read more about exercise.
The bottom line is that sex and intimacy are different for everyone. Although some people want to have sex during some or all of their treatment, others prefer to focus on treatment first before having sex again. The choice is entirely yours and should be based on what you want and need.
Resources for getting help with sexual health and function
If you're having problems with sexual health and function, body image, or intimate relationships during or after treatment for breast cancer, there are now many more resources available to help, including specialists and clinics, support groups, educational resources, and more.
Read more about sexual health resources.
Dating after breast cancer
Dating might feel different after a breast cancer diagnosis. You might be wondering how to talk about your cancer history or changes to your body when you meet someone new. Sometimes it's also hard to know when you'll feel ready to start dating again. Read tips on getting back to dating from experts and people who've dated after breast cancer.
— Last updated on August 22, 2024 at 7:10 PM
