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Under the Sheets

Sexuality and intimacy issues often overlooked in breast cancer survivors. 

BY ELIZABETH WHITTINGTON @eyoste
PUBLISHED WEDNESDAY, OCTOBER 7, 2009
Although usually an afterthought following a breast cancer diagnosis, intimacy and sexuality issues associated with cancer and its treatment are common among patients and survivors, say experts.

Unfortunately, these issues are often not discussed between patient and doctor, either during the treatment decision phase or afterward. Sally Kydd, PsyD, licensed clinical psychologist and breast cancer survivor, says it would be ideal if health care professionals who interact with newly diagnosed women raised the issue of how cancer treatment can affect a woman’s sexuality. “Since, now days, most women survive breast cancer, rather than die of it, I believe it’s time to focus on quality of life issues, like sexuality, at the beginning of treatment.”

And similar to fertility and long-term effects, sexuality is slowly being recognized as an important issue in both the medical and survivorship communities. 

“The fertility issue got addressed a lot more once it came to people’s attention, but sexuality, which affects a much larger group of cancer survivors, still remains kind of a stepchild,” says psychologist Leslie R. Schover, PhD, author of Sexuality and Fertility After Cancer. However, there has been a greater awareness of the issue over the past few years, and improvements in helping patients and survivors—and their partners—overcome these problems.

There are many different reasons why survivors may have a decrease in libido, ranging from emotional issues to the physical, and often a mixture of both. Finding the cause is the first step in determining how to overcome each problem.

Emotional issues may stem from body image changes, such as being self-conscious about scarring, lack of breasts, or weight gain. Talking with a counselor or a support group may help you to overcome any body image issues you may have. Regular exercise and improving your diet may also help with weight loss, energy, and your overall mood.

Physical issues, such as vaginal dryness or loss of feeling in the breasts, may also create havoc in the bedroom. Knowledge of certain side effects before treatment begins can help survivors prepare for them and may even be a determining factor in deciding on treatment. Kydd, who co-authored Intimacy After Cancer: A Woman’s Guide, says she was fortunate to have a surgeon who told her that a double mastectomy would mean she would not experience sexual pleasure from her reconstructed breasts.

“He gave me the opportunity to evaluate different treatments prior to having surgery,” she says. “It didn’t change my mind, but I was grateful for the opportunity to make an informed decision about treatment.” 

If breast touching was once erotic, the loss of feeling in the nipple and surrounding tissue may negatively affect intimacy between partners. If breast touching no longer arouses you, due to either loss of sensitivity, being self-conscience about scarring, or it reminds you about the cancer, you may need to talk about what else your partner can do to arouse you. It may be that you and your partner may need to find other erogenous zones, such as the neck, feet, hands, and inner thighs, or other methods of arousal.  

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