Sex After Breast Cancer, Tips For Talking To Your Doctor (Video)
Breast Cancer: Sex and Intimacy
What are common psychosexual problems that couples experience?
Many couples fall into a pattern of sexual activity that is not satisfying to one or both partners and do not know how to make necessary changes. A breast cancer diagnosis may be the catalyst that allows discussion and experimentation to take place. Our culture stresses female breasts as an important part of sexuality and femininity; thus, losing a breast or both breasts to cancer can affect your sense of value. Women who were confident about their sexual attractiveness before breast surgery may feel insecure afterward. If breast and nipple sensitivity increases a woman’s sexual pleasure, she will experience a loss when it is gone. Although the skin will again become somewhat sensitive, rarely is the sensitivity the same as it was before surgery. A woman’s breasts do not define who she is as a woman or a sexual partner. Not all women choose to have reconstruction after surgery; however, sometimes women find a lot of sensitivity from their scar and derive sexual pleasure from this. Some may feel guilty about this new-found pleasure. Others experience pain and discomfort after surgery that do not resolve; thus, the breast area no longer provides sexual pleasure. Partners often report that the reconstructed breast is just as sensual as a normal breast.
Many other factors besides a breast cancer diagnosis could affect a woman’s satisfactory sexual life. Cardiovascular disease, atherosclerosis, hypertension, and diabetes may negatively impact healthy sexuality. In woman, diabetes has been shown to lessen desire, arousal, lubrication, and orgasm, which damages nerves in the clitoris and penis, literally stunting the ability to experience sensuality. Other factors like aches and pains associated with aging or sleep disorders decrease sexual desire and performance. Obesity is also associated with lack of enjoyment of sexual activity, lack of sexual desire, difficulties with sexual performance, and avoidance of sexual encounters.
Smoking, alcohol, drug abuse, stress, and side effects from almost any medication, particularly antidepressants, can impact sexual arousal and response at any age. Significant psychological factors that affect loss of sexuality include perceived unattractiveness. Sexuality in humans is made of desire, arousal, orgasm, and resolution. Each phase is governed by corresponding brain chemicals, along with contributing hormonal influences. When the brain is experiencing a chemical deficiency in any of the four primary areas, the desire for sex diminishes.
Terms:
Cardiovascular disease – The class of diseases that involve the heart or blood vessels (arteries and veins).
Atherosclerosis – A condition in which fatty material collects along the walls of arteries.
Hypertension – High blood pressure; an abnormality in arterial blood pressure that typically results from a thickening of the blood vessel wall. It is a risk factor for many illnesses, including heart attacks, heart failure, and stroke, or end-stage kidney disease.
Diabetes – a medical disease characterized with abnormal sugar metabolism and levels.
What is sexual self-esteem?
How you view yourself as a sexual person is often defined as sexual self-esteem. If you have a positive sexual self-esteem, then you have embraced your sexual identity, think of yourself as sexy, and are embracing your body as it has changed with age and disease. In contrast, those with negative sexual self-esteem feel unattractive, not sexy, and often ashamed of their bodies and how they perform sexually.
When you are bald and nauseated from cancer treatments, sensuality and sexuality may not be important, but intimacy may be on your mind. You may need reassurance about your sexuality and desirability. Ask your partner for what you need in order to get reassurance. If you do not have someone in your life, find other ways to make sure that your sexual self-esteem is intact. Most women are comfortable with their degree of femininity, but many women are unsure of themselves regarding sexuality and their roles with regard to pleasure and pleasing.
Significant psychological factors that affect loss of sexuality include perceived unattractiveness.
What body image issues might a woman with breast cancer experience?
Women may see themselves as too fat, too tall, too short. They are bombarded in the media with the perfect body, perfect face, and perfect hair and are told what they must do to achieve perfection. Plastic surgery is rampant, as is dieting, exercising, and women’s focus on their outward physical appearance.
If you do not feel attractive before your diagnosis, you may have lowered self-esteem after treatment or diagnosis. Certainly, having one breast or no breasts at all affects your self-image and feelings of adequacy. In our culture, breasts define who we are as wives, lovers, and mothers. A bare breast, or a hint of a bare breast, has immediate sexual inferences or indications. Thus, the loss or a change in the shape or sensation of a breast often has a significant impact on self-esteem. Our culture is enamored with youth, and unfortunately, aging affects all parts of the body linked with sexual function, both internally and externally. With a breast cancer diagnosis, you may have a woman who has great difficulty seeing her as desirable.
What are sensuality, intimacy, and love?
Both men and women confuse lust with love, sexuality with the sex act, sensuality with appeal, and intimacy with sexuality. This confusion can lead to a misunderstanding about how relationships change and mature over time.
Being “in love” is depicted in the media as a time of high lust, when couples cannot stand to be apart from each other. Love often signifies a joining as one in your life journey. Lust is often perceived as carnal drive that lessens with the length of the relationship. As this lust lessens, sometimes you may falsely think that you are “falling out of love.” However, a relationship may progress from erotic sexual lust to the deep commitment of lasting love. Irrespective of which phase of “love” one is in, when you are dealing with cancer diagnosis and treatment, it is important to feel desired. Feelings of desirability are also linked to preference. What do I think is sexy? What about when I dress a certain way? Walk a certain way? Speak in a certain tone? Take some time to explore the notions of love, sex, intimacy with and without your partner. You will be surprised at your differing or similar perspectives. This is an exercise in communication, and you will be closer to your own sexual self and that of your partner.
What is loss of sexual interest in intimacy or sex?
Cancer may cause much of the loss of interest in intimacy for women. Those who had active breast caressing as part of their sexual repertoire will mourn the loss of this activity, leading to feelings of loss, ultimately demonstrating clinically as lowered sexual desire. Chemotherapy causes both nausea and fatigue and affects a woman’s sexual hormone levels, such as estrogen, progesterone, and testosterone, all factors that reduce feelings of desire. Some of the medications discussed earlier to help keep disease stable can also have effects on the sexual response cycle, including desire.
The emotional impact of the diagnosis alone causes many women to experience anxiety and depression. Many women suffer from hypoactive sexual desire disorder (HSSD). New exciting scientific developments are underway for possible treatments for women who are suffering with this condition.
Often, in the face of treatment, sexual wellness is not a priority. Nurture yourself. Take an adult time out! Spend quality time alone; it will make you a better mother, wife, and daughter. Set limits, and make yourself and your relationship, sensuality, and sexuality a priority. In our busy lives, we let our jobs and careers and family obligations interfere with our need for intimacy. Quick sexual encounters may be exciting and satisfying, but there is also the need for reaffirmation that you are loved intensely. Deeper intimacy and emotional connection can be built when time and energy are present and you make yourself and your partner a priority.
Sexual health has been linked to overall health. Focus on your intimate partnerships. Love, sex, and intimacy will help you heal and recover from the devastation of cancer.
Term:
Hypoactive sexual desire disorder (HSSD) – Lowered sexual interest that is often characterized by absence of sexual thoughts and fantasies-it is associated with distress.
Sexual health has been linked to overall health. Focus on your intimate partnerships.
What is psychosexual counseling?
Concerns about sexuality and intimacy are very private matters, but you may need professional counseling in this area, both before and after a breast cancer diagnosis. Many healthcare providers are reluctant and uncomfortable to enter into these discussions. Sometimes the provider will need you to broach the topic, and if you feel discounted, do not get discouraged! Think about seeking those who are sensitive to your sexual wellness concerns.
Psychosexual counseling can help a woman understand that beauty truly comes from within and that losing a breast should not affect your self-image. It involves meeting with a therapist and talking about what is happening in your sexual life as a result of cancer. Be certain to ask about credentials and experience in dealing with breast cancer patients.
What is marital counseling?
Many spouses or partners feel very scared and confused during the process of a breast cancer diagnosis and treatment. The partner, lover, boyfriend, or spouse cannot do the surgery and often cannot help with the treatment. They often feel helpless and do not know what to do or say. They may experience a strong desire to take care of and protect the spouse, to be close and loving with their partner, but may be afraid to approach her sexually or intimately. Often, so much about their relationship changes in a short time. Partners often become caregivers and are suddenly 100% responsible for domestic duties and childcare during cancer treatment. Their role in the dyadic relationship may change dramatically. They often mean well but sometimes are confused about how to be supportive and encouraging without pressuring their partner.
The patient may deal with the physical and emotional impact of surgery, radiation, or chemotherapy. She may fear how her cancer will affect her relationships and may have feelings of not being the best mother or good wife and causing her family pain. She may even feel guilty that she now is unable to fulfill her duties as childcare giver, mother, housewife, and lover. She may also be upset about her inability to maintain social and employment commitments, thus directly impacting the family’s financial well-being.
Little or no information is available to help couples and families get through this crisis. Sometimes couples function well with traditional sex roles (e.g., the wife attended to the children and home), but when roles change due to illness, the partner must now take on new responsibilities and may feel tremendously overwhelmed. Unconscious anger and resentment may build and need to be addressed. Sometimes other family members, mothers, mothers-in-law, or others, move into the family home to provide assistance, and this may increase marital strain.
Privacy issues are also a consideration when outside caregivers are involved. Counselors are trained to deal with a couple’s marital conflict and issues. When cancer invades a marriage and relationship, you may need some assistance in reestablishing effective and loving communication styles. Sometimes you may need an impartial listener who can help guide you to a sense of relationship harmony. Seek professional psychological couples counseling if your relationship has suffered as a result of the breast cancer. Make sure that you and your partner are comfortable with the counselor’s care. Sometimes medical insurances will cover or reimburse the fees for counseling; thus, always check your benefits with your medical insurance carrier.
