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Go backEmbracing Your Sexuality

By Becky Zuckweiler, MS, RN

Becoming sexual after having breast surgery can be one of the biggest hurdles you go through during your recovery. Since our breasts play such an important part in our sexuality, it is natural to worry about how we are going to reconnect without them. We fear that we are unattractive to our partner and worry about whether we can have a full and satisfying sexual experience after our mastectomy. We worry that we will be so uncomfortable in our changed body that we become inhibited in how we dress and conduct ourselves sexually. Many women who have had both breasts removed are concerned that they will not be able to find a way to replace the erotic sensations and sexual pleasure that their breasts provided. We also worry about initiating sex. Should we initiate sex, or will that put our partner on the spot of having to make love to us when our partner isn't ready or worst of all, our partner thinks that we are now ugly and untouchable? Our rational mind knows better, but our fears are not always based on rational thinking, so we can create some pretty big worries.

The changes in us make our partners feel confusion and uncertainty. Today's male is having to disprove the cultural attitude that men are sex-hungry and insensitive to the needs of women. It is true that a healthy male is interested in sex but most men are not driven by it, and are sensitive to the needs of the woman in their life. This sensitivity, in fact, makes it very tricky for men. They are supposed to support us and accept us with our new bodies, and still be attracted to us, but they do not want to be accused of "only caring about one thing." They want us to know that they love us more than our bodies and care about what we are going through. Our partners are often acutely aware of how close they came to losing us and are dealing with their own fears.

Your partner has seen you go through a great deal of physical pain, and the last thing he wants is to cause you any more pain. So how and where can he touch you? He wonders what kind of feelings of insecurity or grief will he unleash in you if he touches any part of your chest. If he totally avoids your chest, will you interpret that as a sign that your chest is ugly and repulsive to him? Often, one of his greatest initial fears is that, in fact, he will think your chest is repulsive and will not be able to relate to you sexually any more. He knows how important it is going to be to you that he be able to accept and like your body. He may fear that maybe he is one of those superficial men who cannot be there for you. He thinks he has more depth than that, but worries about failing you and adding to your tremendous pain.

You and your partner are likely to be experiencing a whole range of thoughts and feelings that will need to be talked about.

Sex and sexual intimacy do not start in bed. Open communication of sharing our feelings and listening closely to our partner's feelings is the building block for being able to please and be pleased emotionally and sexually. You and your partner are likely to be experiencing a whole range of thoughts and feelings that will need to be talked about. Sex is about tenderness and vulnerability. It is a time when we should be able to let our guard down and open up our hearts to give and receive love and acceptance with our partner. If you start with this belief, communicating about sex will flow more naturally.

There are two basic ways to return to your sex life. The first approach is to go back to your old style, or you can build an entirely new structure for a new sex life. Women with comfortable, safe, satisfying ways of relating sexually are able to return to this solid foundation as they become sexual again. Women who have established open communication and deep understanding with their partners can make the adjustment from sex before surgery to sex after the surgery fairly easily. Such women know they are loved first as a person, and that sex is just one way in which the love is expressed in a relationship. This foundation of love will support the couple during the insecure time they go through in the adjusting to the loss of a breast.

Of course, both partners will need reassurances. The woman will need to know that she is still sexually desirable even though her body is changed. Partners need reassurances that they are being considerate enough and supportive enough. Most partners are extremely concerned about not wanting to add to her pain in any way, and need to know when and how to physically touch her body as it is healing and how and when to touch her to express sexual desire. A strong relationship built on a foundation of love will support a couple as they struggle together to regain physical intimacy.

For some women, instead of finding the "old and usual" sexual routines a comfort, they may find that they make them angry and impatient. They decide after coming through the trauma of breast cancer and surgery that they deserve more out of life and are going to break out of their old, binding attitudes toward sex. After going through so much physical and emotional pain and fear, some women decide that they do not want to give up any more opportunities to get the most out of life. They decide they need to balance out some of the pain in their life with more pleasure, and sex is one of the ways to try to even the scale. There are many women who have been married for 20 years but yet have never had an orgasm. If this is your situation, you may decide it is time to include your needs as well as well as your partner's.

I encourage you to make room in your life for your sexuality. Allow yourself to think about and share your preferences with regard to styles of clothes, fragrances, music, alcoholic beverages, atmosphere and how you like to be sexually touched. Sharing them with your partner allows for a special, close connection. At 52 years old with no breasts, my husband and I find great sexual pleasure and it is fun to know I am as frisky as I have ever been. Don't settle for less, expect more!