Telling Your Spouse/Partner
Most often, your spouse/partner knows from the beginning. Open communication with your spouse/partner will be the most helpful to you during breast cancer treatment. You will be experiencing many side effects from breast cancer treatment and many changes in your concept of self, body image, physical changes, and changes in the energy you felt prior to breast cancer. This has a significant impact on your partner, and although you may not feel that he understands your journey, he will be experiencing a parallel journey alongside you.
Expect to feel differences as you go through breast cancer treatment, especially in your body integrity, your energy level, and the appearance of your breast or breasts. Acknowledge the differences, be aware of these feelings, whether of change or loss, so that you can work through these changes yourself. This will help when sharing your feelings with your spouse as your body continues to change and feel different. Be aware that you may be struggling with your new appearance and may be sad that your body does not feel or look the same as it did before your breast cancer treatments. You may be more self-conscious with your loved one about your appearance, or you may notice changes in your sexual health. Open communication with your loved one will promote a safe and comfortable environment to help you be yourself. Discussing changes in your sexual health with your doctor may help you learn about coping strategies to maintain intimacy during breast cancer treatment. Some of the side effects from breast cancer treatment will have an impact on your energy and your ability to maintain good sexual health during and after treatments.
Being Intimate During Treatment
During breast cancer treatments, many of the side effects fight against your desire to be intimate with your partner. As your body is changing, your physical and emotional energy is depleted; your lack of sexual interest seems to take over while you are trying to maintain a sense of normalcy in your life. It feels like you need every ounce of energy that you can muster up just to survive the day. So who is thinking about sex? Most likely, your partner will be. You may find yourself struggling with your own needs and those of your loved one may be the last thing on your mind. The good news is that you, too, will be thinking about your sexual health and needs at various times during your own breast cancer journey. Some women are able to continue with their previous sexual patterns during their treatment while others may find it very difficult. It is important to communicate these feelings to your partner, because he can be of great support to you and help you to feel complete. If you find that your partner is not understanding during this time, you may want to focus on returning to a healthier place in your physical and emotional being before addressing your concerns. You may also want to refer your partner to a support group for guidance and understanding of your support needs so that you do not become his support person.
The loss of libido or sexual desire, whether before or after breast cancer treatment, will vary from individual to individual. The change is most significant when you are premenopausal before treatment and were thrown into an early menopause. Your body feels different and it will take your mind and spirit time to catch up to your new body experience. One of the side effects of being thrust into early menopause can be a loss of interest in sex. Individual or couples counseling may be helpful. Remember, you need to be at peace with your body and with its changes.
Some suggestions that have been made to help with your sexual health are recognizing that your desires and energy may change during breast cancer treatment. Tips that have been shared by health professionals and other women living with breast cancer are the use of vaginal moisturizers or lubricants to lessen discomfort during sexual intercourse. Also, consider talking with your partner about engaging in increased foreplay and experimenting with position changes to see if that will help. Medication can also have a significant impact on your sexual health and desires. You may want to discuss this with your doctor to see if changes in medication can be made.
All in all, it is understandable that as you are facing a life-threatening illness, sex may not be first and foremost on your mind. Helping your partner, who is experiencing his own journey alongside you, through open communication and expressing intimacy in other ways, will sustain and strengthen your relationship. Intimacy is the mainstream of sexual health and is at the core of the human experience. Enjoy it when you and your loved one are ready.
Women often have associated the use of tamoxifen as affecting their desire for sex and their loss of libido, because of side effects that include hot flashes and sleep interference. These side effects can lead to a general feeling of fatigue, which is what can affect your interest in sex, but studies show that the drug does not directly affect the libido.
Being Intimate Post-Treatment
When you have completed your breast cancer treatments and some time has gone by, there is the expectation that things will get back to normal. Your sexual health is the most personal and life-changing part of your experience. Your prior physical and emotional health has changed from the experience and it may be difficult for your partner to understand as you move further away from your breast cancer diagnosis and treatment. The old adage that time heals doesn't specify how long it will take, but both partners will at some level struggle with returning to the relationship's previous sexual health. You may discover that you do not have the same desires and your present sexual activity will be different. With breast cancer treatment, many permanent changes occur in the body and you and your loved one may need to adapt to those changes to get to a higher level of intimacy. Touching, rubbing one's feet or back, a quiet walk with your loved one at your favorite place, or a romantic dinner for two may be all you need during those dry spells.
In Her Own Words
It was an early morning call I received from Carol, telling me she wanted to come over to talk with me. I knew then her cancer had come back and she was so scared. It was a little under five years from first onset of breast cancer. At this point, when Carol started her chemo treatments, I would go with her, I never missed one. This was so important to be there for her. I helped, because I would keep talking to her through it all. At one point she said, “Dottie, I know what you're doing,” to take her mind off of this whole treatment, because it made her so sick.
— Dottie, age 61, sister