by Kathy Steligo
Intimacy is a treasured component of most successful relationships, but that might be the last thing on your mind as you leave your diagnosis and treatment behind. Cancer changes you, and sometimes those changes extend to the most personal aspects of your relationship with your partner. Many survivors make the transition with no ill effects, moving forward with a renewed commitment to life and all it brings, including a stronger, more intimate bond with their partner. Others experience sexual dysfunction. A study published in the Journal of Sexual Medicine found that 70% of breast cancer survivors who described their sex lives as satisfying before treatment experienced sexual function problems approximately 2 years after diagnosis.
Acknowledge physical barriers to intimacy
Lingering effects of cancer can disrupt normal life and take a toll on intimacy, long after the last chemo treatment is completed or surgery stitches are removed. When treatment ends, your partner may expect you to pick up where you left off, but it isn’t always easy to simply move on or just “snap out of it” when you are sad, in pain or exhausted. You can resolve these issues and get your love life back on track, but it sometimes takes time, effort and a bit of trial-and-error to determine what works best for you.
Start by acknowledging physical issues that stand in the way of the intimate relationship you want, and make a plan of action to improve each one. Do you frequently feel worn out? Many survivors say that tending to children and running the house takes all the energy they can muster, leaving strength or interest for little else. If fatigue remains a problem, be sure to take good care of yourself.
- Get enough sleep. Your needs are unique to your own body and habits, but in general adults need six to eight hours a night, including deep REM sleep, which is sometimes unattainable in shorter naps.
- Eat balanced meals to give your body the nutrition it needs, and as soon as your physician clears you for exercise, try to be physically active each day. Begin slowly, gently increasing your routine as you gain strength and confidence.
- Try gentle yoga—it releases stress, while enhancing focus and flexibility. Exercise improves blood circulation, strength and produces endorphins, which can boost your mood. It can also reduce treatment-induced menopausal symptoms that affect intimacy, including hot flashes, insomnia and restless sleep.
- Premature menopause can also cause vaginal dryness, making intercourse painful. If over-the-counter vaginal moisturizers don’t help, ask your doctor whether Estring or Vagifem, medications that release low-dose estrogen to the vaginal walls, is appropriate for you.
Heal Your Spirit
Like your body, your mind needs time to adjust and heal, and as you work to improve your physical well-being, you may need to address emotional issues as well. Cancer is a powerful ordeal that can undermine self image and self confidence, which may in turn create distance between you and your partner. You may be impatient with your recovery, saddened because your hair hasn’t fully returned, or worried that your cancer might return. You may look at your scars and feel unattractive or unwanted. Remember that the brain is the biggest sexual organ we have. Combat these negative thoughts with powerful, positive self-talk to change the way you see yourself and the way you think about your body. Tell yourself that you are vital, whole and desirable. Give yourself credit for what you have accomplished. Gina Maisano, a two-time breast cancer survivor and author of Intimacy After Breast Cancer, says, “Think of what you did. You heard the scariest words a woman can hear, yet you fought and you won."
Talk About It
Your partner may feel rejected or afraid to approach or touch you, particularly if you shut down emotionally. As difficult as it may be, it’s important to discuss openly and honestly how you feel and what you want. Discuss together how you can change your sexual repertoire to satisfy you both, and ask for patience if you need more time to achieve arousal. Sally Kydd, a clinical psychologist and co-author of Intimacy after Cancer: A Woman's Guide suggests the following tips:
1. Talking about sex is best done outside the bedroom.
2. Say what your partner is doing right and what else you'd like, rather than what your partner is not doing or doing wrong.
3. Talk and then listen to your partner. Talk, for example, about your fears and what you like and listen to your partner’s concerns and preferences.
Rekindle your romantic relationship. Spend time together, creating new ways to enjoy different levels of intimacy. Hold hands and hug. When you don’t feel “in the mood,” try doing whatever gets you in the mood. Kiss and cuddle. Share a long warm bath or a romantic dinner. Listen to your favorite love songs.
Work towards being comfortable with the new you. Explore your new body, looking and touching to learn what feels best. If your breasts were prominent in lovemaking before your diagnosis, your lost sensation after mastectomy (whether or not your breasts have been reconstructed) may be disappointing. But you can still enjoy the sensation of touch. Concentrate on areas that still provide pleasure—your inner thigh, along your neck, the tops of your breasts—instead of those that do not. Maisano suggests tracing the end of a pencil along the upper border of your reconstructed breasts to discover where you have most sensation, then ask your partner to focus on those places.
Love and be loved
The most erotic experience of all may be the realization that your partner still loves and wants you. Let yourself heal, grieve your loss, and deal with the aftermath of your cancer. If you can’t seem to shake negative thoughts or feel depressed beyond your control, talk to your doctor about medications that can help without affecting your libido. If your love life remains unsatisfactory, ask for a referral to a psychologist or a sexual therapist. Recognizing problems, taking action and getting professional help when you need it will help you achieve the intimate satisfaction you want.
Resources For You
Read the study referenced in this article, from Science Daily.
Get more information about the book, Intimacy After Breast Cancer, by Gina Maisano.
Visit the Intimacy & Sex section for even more discussion, at TheBreastCareSite.com.