Sexuality is not based on your outward appearance but rather a culmination of your sensual inner being; how you view yourself, your body, and your relationships with your life partner. With breast cancer come many fears, fears that are not based in truth. The important aspect of sexuality is communication with your partner and facing these fears. A partner may have a fear of catching cancer from you, which is not possible. Without open communication, this fear may not surface. Once fears are out in the open, they can be discussed and relieved.

Hair loss in a society that promotes all things physical, particularly the importance of outward appearance, can make the most confident woman feel self-conscious when looking at herself or being seen by a loved one when she has a bald head. Having a mastectomy with or without reconstruction surgery carries an element of uncertainty, including the reaction to the loss as well as the reaction of your partner.

There is also nothing attractive about the nausea and vomiting that often accompany chemotherapy treatment. It is important to be true to yourself during this time and balance your sexual needs with that of your partner. Again, this is an individual experience and your reactions and feelings are yours only and need to be respected by those you love. Resuming sexual activity is a personal choice, including when and how often that happens. Depending on your breast cancer treatment and your options, you should consult your doctor or surgeon about how long you should refrain from sexual intercourse. For example there may be no restrictions if you have had a lumpectomy with radiation or hormonal therapy, as opposed to a more involved treatment course that includes a total mastectomy and reconstruction surgery. Intimacy at all levels is encouraged no matter what breast cancer treatment you are having. Intimacy with your partner can also take forms as simple as holding hands, going for walks, or sharing your innermost concerns and passions.

The other side effect of breast cancer treatment that has an impact on sexuality is early menopause. And taking anti-estrogen drugs such as tamoxifen may cause symptoms related to menopause. The likelihood of going into early menopause depends on the woman's age and the doses used in their chemotherapy treatment. Menopausal symptoms may be annoying but do not impede resuming your previous sexual practices. Managing some of the side effects that are part of the menopause experience can help to alleviate some of these annoyances.

Vaginal dryness and thinning of the vaginal tissue can often interfere with sexual intercourse. This thinning is a result of diminished estrogen in your body from chemotherapy, hormone replacement therapy, or being put into early menopause by your breast cancer treatment. There are many products on the market today. Ask your doctor for recommendations. Products that may be helpful include Replens, which can be used as a daily vaginal moisturizer, or Astroglide, another product that can be used during sexual intercourse. Other options you may want to consider are an estrogen cream or an estrogen ring, which introduces a low level of estrogen directly into the vagina. It is recommended that you talk with your oncologist before you choose any of these options, because there may be unique factors in your breast cancer scenario that your doctor may want to caution you about. Estrogen replacement at any level in a women's life has been a topic of controversy lately among physicians and consumers. Breast cancer certainly puts a different spin on the issue and needs to be part of your decision-making, with an emphasis on the fact that quality of life issues are part of human sexuality.