What sexual intercourse means to us 

Intimacy and sexuality is an integral part of being human. We make love for a number of reasons: 

• to be close to one another
•  to experience cherishing a loved one and being cherished, 
• to demonstrate love
• to satisfy physical desires
• to give and receive pleasure
• for sexual release
• for procreation 

So, does having breast cancer mean the end of sexual intimacy?

Not at all. it may well seem like it at first, but sexual pleasure will return if it is important to you.

The important thing is to practise patience and not force anything.

Take charge of your life after the initial uncertainty by finding out as much as possible about your diagnosis and treatment. Share your feelings with your partner to create a sense that you are a team working through things together. 

Allow your partner to nurture you to create emotional intimacy between you.

It may be hard at first, but gently communicate with your partner and make an effort to rekindle communication and emotional intimacy to help you build towards greater physical and sexual intimacy. 

What happens if I feel depressed all the time or have a low libido?

Depression is a common side effect of the whole experience of breast cancer. A low libido is a common symptom in patients who have to have chemotherapy. However, this side effect disappears with time.

Sexual activity, including intercourse, can be resumed as soon as both of you feel ready. The lateral (side to side) position will prevent pressure on the scar. What matters is what both of you are comfortable with. 

The key to intimacy is understanding, love and finding pleasure in each other. Caresses and touching convey acceptance in a way that words can’t. Sometimes intimacy starts by just spending time together again. 

My relationship is rocky, what should I do?

Sadly, cancer has the reputation for putting a finger on the trouble spots in a marriage or relationship. Very often, partners wanting to be supportive say the wrong thing, or women reeling from the shock of diagnosis misunderstand a gesture. 

The loneliness of being a cancer patient can’t always be shared, even with a person closest to you. The strongest marriage or relationship may take strain, so don’t be too proud to seek help. And don’t listen to people who tell you to just get on with it and be grateful!

One thing cancer should convince you of is to live your life the way you want to. Don’t be afraid to ask for what you need, but also to express your boundaries. A loving and committed partner will be patient and supportive, and ready to meet you where you are.

Communication as foreplay

Communication as foreplay is very important. Use words or your hands to tell your partner when you are ready to be touched, when and how you want to show your breasts, what feels good. Discuss what makes you feel more comfortable: being in the nude, wearing sleepwear/a bra/camisole/prosthesis.

The effect treatment has on your libido depends on the type of treatment you have and also the quality of your sex life before the diagnosis.

Hormone therapy like Tamoxifen may cause hot flashes, vaginal dryness or irregular menstruation. Ask your doctor to prescribe a vaginal lubricant.

Can I get pregnant while undergoing cancer treatment?

Yes you can. 

It is best to use contraception while undergoing treatment because chemotherapy and hormone inhibitors like Tamoxifen can cause serious defects in a foetus. Condoms and other forms of contraception can be used.

How do I get things going with my partner?

• Try gentle caresses and massage rather than intercourse. Avoid touching genitals and breasts, this will help both of you to relax and experience sensual enjoyment.
• Bathing together by candlelight with soft music will not only relax you, it will encourage sensuality.
• Plan times when you can relax and be together without being disturbed.
• Agree beforehand to tell your partner if you experience any pain or discomfort.
• Make time for foreplay and use plenty of lubrication when you decide to go on to intercourse.
• Fantasising about your best sexual experience will increase enjoyment.
• Your ability to reach orgasm should not be affected unless you are taking an antidepressant that delays orgasm. This can be prevented by longer foreplay.

The thing to remember is that you have agency to influence the course of your life after a breast cancer patient – including in the bedroom (or kitchen or dining room!) If sex is important to you, you’ll find a way to work it back into your life.