Treating the Sexual Side Effects of Metastatic Breast Cancer

Some people with metastatic breast cancer find the disease disrupts their sex life, which can be upsetting, stressful, and isolating. For other people, sexual side effects may feel minor compared to other physical and emotional side effects.

It’s not always easy to balance your sexual desires with the challenges of metastatic breast cancer. But if sex is an important part of your life, there are steps you can take to reduce sexual side effects of metastatic breast cancer and its treatments.

Bone pain caused by metastatic areas in the bones, especially the spine, may cause discomfort during sex. If sex causes you any pain, tell your partner about it. You may want to try different positions or things other than intercourse. Oral sex, massage, cuddling, or mutual masturbation also can be satisfying. Placing a pillow or wedge underneath a tender area may help ease pressure or friction.

Kristin Rojas, MD, FACS, who studies how to manage sexual side effects in women with any type of cancer, recommends that anyone with metastatic tumors in their lower legs, feet, pelvis, or spine ask for a referral to a pelvic floor physical therapist. The American Physical Therapy Association’s Academy of Pelvic Health Physical Therapy has a locator tool to help you find a licensed physical therapist who specializes in pelvic health.

Treatments for metastatic breast cancer can cause fatigue, which can affect your sex life and your intimate relationships. There are ways to manage fatigue, including exercise, eating a healthy diet, meditation, and yoga.

There are resources to help you exercise safely at any level, including trainers who can suggest ways to modify exercises to fit your abilities.

A hot flash is a sudden, intense, hot feeling on your face and upper body that can be accompanied by a rapid heartbeat, sweating, nausea, and other symptoms. Hot flashes can affect your sleep, your concentration, and your sex drive. Exercise, medicines, and acupuncture are just a few of the solutions that can help.

Sexual desire, also called libido or sex drive, is your appetite for sex. Just as some treatments for metastatic breast cancer may cause you to lose your appetite for food, some treatments also can lower your libido. Some research suggests that people receiving radiation to the brain are more likely to experience a loss of libido.

It’s important to understand how you’re feeling so you can talk to your partner. Many people find help through in-person or online support groups. If you’d rather speak with a professional, there are many sexual health resources available to help you locate one in your area.

It’s common for some people living with metastatic breast cancer to feel anxious, depressed, or grief-stricken over any losses they’ve experienced — such as the loss of hair and parts of the body. All these emotions can zap your desire for sex.

Mental health support, such as counseling and therapy, can help. Other things you can do on your own, such as exercise, yoga and other complimentary therapies also can boost your mood.

While some people may feel proud of their scars from surgery and see them as a symbol of strength, others may find them unattractive or worry their partners do. These feelings can affect your level of comfort with being naked or touched during sex.

If you’re feeling self-conscious about your surgery scars, talk to your partner about how you’re feeling and what might make you feel comfortable. Feeling comfortable can help you feel sexy.

Vaginal dryness and tightness happens when estrogen levels drop, causing the walls of the vagina to become thinner, less flexible, and to produce less lubrication. Treatments for metastatic breast cancer can cause these changes, and they can make sex painful. But there are a number of treatments for vaginal dryness, including moisturizers and lubricants, medicines, topical estrogen, and dilators. There is also the Ohnut, a set of soft rings that control the depth of penetration.

Some metastatic breast cancer treatments can cause weight gain or loss. If weight changes are affecting your self-esteem, your sexual desire, or your energy level, talk to your medical team about a nutrition and exercise plan so you can get to and maintain a healthy weight that makes you feel good. 

Sexual Health, Intimacy, and Metastatic Disease: Reclaiming Your Sexual Self

Feb 15, 2017

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While many people believe “intimacy” means sexual intercourse, sex is only one aspect of intimacy. Affection, honesty, closeness, and a sense of safety are also part of intimacy. Sometimes, the bond that sex typically strengthens can also be reinforced in other ways — by spending time together, having an honest conversation, or by nonsexual touching and caressing.

Living with metastatic breast cancer can create new physical challenges and feelings that interfere with intimacy. Redefining how you think about sexual desire and clearly communicating your needs can help you get what you want and need.

It makes sense to talk to your care team about any sexual side effects you may be having so you can find ways to make sex comfortable, pleasurable, and satisfying. If you’re female, it’s also important to have regular gynecological check-ups.

Just like the people they care for, some doctors may be uncomfortable discussing sex. Don’t let this stop you from telling them about your concerns and asking them about treatments. Here are some tips:

Make sure your medical team understands that sex is important to you. This way, they can prioritize addressing your needs.

Be as specific as you can about any issues you’re having. For example, you could say, “Since this course of chemo started, intercourse has been painful,” rather than simply, “Sex is painful.”

Ask if your doctor has resources or referrals on sex and metastatic breast cancer. Some facilities can link patients to helpful information and experts. You can also check online resources like the American Cancer Society’s page on sexual side effects. The American Association of Sexuality Educators, Counselors and Therapists also offers a tool that can locate professionals in your area.