September 1, 2021

Exploring Intimacy Changes Post-Breast Cancer

Many women find that breast cancer diagnosis and treatment seriously disrupts their sexual lives. First, there are the most obvious issues — the physical changes, exhaustion, nausea and pain from treatment, self-image, empty energy reserves, and the emotional chaos from the diagnosis itself.

Cancer treatment can dampen your libido, make sex painful (or impossible), change your ability to orgasm and even render your private parts less sensitive.

Chemotherapy and radiation can damage the mucous membranes in your mouth, nose, eyes, ears, and yes, vagina, penis and anus. Radiation can also burn your skin, and turn soft, sensitive tissue thick and tough. Anti-hormone treatments, put a brake on intimacy— even cuddling is out when hot flashes make people uncomfortable. Blood flow keeps our private areas plump and moist (what makes sex great!); and both [chemo/radiation] reduce blood flow, causing these tissues to thin and tear.

Patients often try to get things rolling after recovery but can have difficulty — lost erection, vaginal pain — and they won’t know how to talk about it. After multiple attempts, sex can become awkward, and they give up.

At this point, neither partner wants to bring up this topic.

Partners often act as caregivers and, once treatment is over, have trouble leaving that role.

This happens with couples in their 30s and couples in their 70s, with mixed-gender couples and with same-gender couples. It effects couples of all kinds equally.

Perhaps the most frustrating change in your sexual life is the loss of libido, of “those urges.” You’ve lost your hair, your breast is altered or gone, you’ve put on weight, you have no energy, you’re tired, you’re nauseated, and you hurt in new places. Not ‘sexy.’

Keeping intimacy in your relationship both during and after your breast cancer ordeal is critical to your overall recovery. And single women who want to become part of a relationship worry how breast cancer will affect their prospects, about how and when to tell those prospective lovers about their condition.

I tell my patients that their breasts may be crucial part of her sexual life before the discovery of her disease. After treatment, the breasts look great—but may have decreased sensitivity. The discussion is always had especially prior to nipple sparing mastectomies.

How to Rediscover Intimacy

  • Talk with your care team
  • Explore products that can alleviate dryness
  • Focus on other kinds of intimacy
  • Don’t let self-care lapse
  • Take your time

Advice from your doctors, or from friends who’ve been down the same road, may help, but some impairment of sexual function is generally unavoidable. Over time, however, things do get better, so keep a positive mindset and look to the future.


Authored by: Dr. Anjeanette Brown, MD