Helping Breast Cancer Patients Reclaim Their Sexuality

Doctor wearing pink ribbon comforting patient

Dealing with breast cancer is not easy, for patients, families, and care providers alike. Even beyond the emotional and physical toll of cancer treatment, there are unacknowledged effects that every patient may face. Breast cancer survivors represent over 40% of all cancer survivors. Of these, around 50% report experiencing some sort of sexual difficulty, with 45% reporting sexual pain.

Chronic illnesses, such as cancer, can create a large burden on sexual health, which often goes unnoticed in care practices. This is not the fault of either the patient or healthcare professional, as not all individuals are comfortable discussing sexual health or think it’s related to cancer care. This is why this article aims to promote a more holistic approach to cancer care, emphasizing the importance of female sexual health in female breast cancer patients.

Sexual Health Impacts

Often, the effects of cancer and cancer treatment are intense. For example, chemotherapy, certain medications, and general fatigue related to cancer treatments can result in a loss of libido. This can be discouraging to many patients and may lead to sexual distress from feeling out of control of their body, sometimes adding another burden to sexual or romantic relationships on top of cancer-related stress.

Chemotherapy and hormone therapies may also cause early menopause, due to lower estrogen levels. This would lead to common menopausal symptoms, including vaginal dryness, which is known to cause painful sex. Additionally, in the case of genitourinary syndrome of menopause (GSM), women may experience dyspareunia or other vulvovaginal or urinary tract symptoms.

Additionally, in the case of mastectomy or lumpectomy, some women may feel less confident in sexual self, especially if the nipples and breasts were heavy erogenous zones for them. Weight gain (due to hormone therapies such as aromatase inhibitors or tamoxifen) may contribute toward a reduction in body confidence, as well as loss of body hair from chemotherapy. This can cause sexual distress and potentially lead to issues with arousal due to the psychological effects of body confidence on sexual health.

Helping Patients Address Cancer-Related Sexual Dysfunction

It’s important to make sure patients feel understood and supported when discussing sexual health. Often, patients may feel awkward or uncomfortable discussing sexual health. They may even feel as though they shouldn’t discuss sexual health with cancer providers. However, sexual health is a large part of a multidisciplinary approach to breast cancer treatment and may need to be approached by care providers first.

For estrogen-related issues, there are very few approved/recommended hormonal options for breast cancer, depending on the cancer’s hormone receptiveness. These options include topical lidocaine, DHEA (limited data on breast cancer patients), and local estrogen such as intravaginal estradiol. It may be beneficial to recommend these to patients if available.

Additionally, for menopausal or GSM-related issues, such as vaginal dryness water-based lubricants (such as SLiquid, Pre-Seed, etc.), paraben free, glycerin free silicone lubricants (such as Uberlube) vaginal moisturizers (for everyday use). For those struggling with sexual dysfunction like dyspareunia, dilators, or vibrators may be recommended to help address vaginal pain, as well as pelvic floor therapies.

In terms of psychological issues, it may be beneficial to recommend cognitive behavioral therapies, or other body confidence-related therapies, as well as recommending a sex therapist. For example, suggesting a patient introduce sexual activity into their life again in a gradual and exploratory manner. Additionally, couples therapy may be beneficial, in the case of disease-related relationship strain, as well as to help communicate changes to sexual functioning and needs.

Conclusion

The effects of breast cancer on survivors can feel quite debilitating. It’s important to consider sexual health as an essential aspect of cancer care in order to help patients fully adapt to their new life after treatment. Clinicians may need to start this conversation with their breast cancer patients in order to provide a holistic approach to care.


References:

Reclaiming your sex life after cancer. Journal of Oncology Navigation & Survivorship. (2019, September 9). https://www.jons-online.com/issues/2019/september-2019-vol-10-no-9/reclaiming-your-sex-life-after-cancer

Sexual health issues in women and cancer treatment - side effects. Sexual Health Issues in Women and Cancer Treatment - Side Effects - NCI. (2022, December 29). https://www.cancer.gov/about-cancer/treatment/side-effects/sexuality-women

Vegunta, S., Kuhle, C. L., Vencill, J. A., Lucas, P. H., & Mussallem, D. M. (2022). Sexual health after a breast cancer diagnosis: Addressing a forgotten aspect of survivorship. Journal of Clinical Medicine, 11(22), 6723. https://doi.org/10.3390/jcm11226723

Other Popular Articles

What Is Jelqing, and Does It Actually Work?

The term “jelqing” refers to a set of penis stretching exercises that some believe can make the penis bigger. Although the practice has gained attention and popularity in blogs and internet forums in recent years, there is no scientific evidence that it is an effective way to permanently increase the size of one’s penis. In fact, in some cases, jelqing may actually cause damage to the penis, so it is a good idea to get all the facts before setting off to try it.

What Is Sensate Focus and How Does It Work?

Sensate focus is a technique used to improve intimacy and communication between partners around sex, reduce sexual performance anxiety, and shift away from ingrained, goal-oriented sexual patterns that may not be serving a couple.

What Is the Average Penis Size?

If you have ever wondered how your penis compares to others in terms of size, you are not alone. Many men are curious to know how their penises stack up compared to the average. Unfortunately, general curiosity can sometimes give way to full-on obsession and anxiety about penis size. This can be an unhealthy and often unnecessary fixation, especially because most men who think their penises are too small have perfectly normal-sized penises.

Can Sex Reduce Menstrual Cramps?

The SMSNA periodically receives and publishes ‘guest editorials.’ The current article was submitted by Mia Barnes, a freelance writer and researcher who specializes in women's health, wellness, and healthy living. She is the Founder and Editor-in-Chief of Body+Mind Magazine.

Having sex while you experience menstrual cramps is healthy and can provide significant benefits. While it might not be the first activity that comes to mind when your PMS or period cramping begins, many people enjoy sex to reduce menstrual cramps, experience increased pleasure and benefit from other advantages. Learn more about having sex while menstrual cramps are happening and how it can help your body.

What Is Edging and Why Do People Do It?

Edging is the practice of stopping sexual stimulation before reaching orgasm to prolong a sexual experience. The term stems from the concept of approaching the metaphorical “edge” of orgasm but stopping before going over the edge.

The Effect of Regular Aerobic Exercise on Erectile Function

Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual activity. As men get older, their erectile functioning may naturally decline due to changes in testosterone levels, cardiovascular functioning, and the potential development of other chronic medical conditions that become more common with age.

Find a Provider

Find a provider who specializes in sexual medicine in your area.

FIND NOW

Subscribe for our Newsletter!

Image