Tiffany T. Garrett, MA, NCC, LPC-S Psychotherapist
Breast cancer is a difficult thing to go through, no doubt about it. It’s difficult enough to have to attend all of the appointments, be poked, pried and subjected to so much medical jargon. But then your sex life, the thing you and your partner enjoy and look forward to, starts to change, maybe even disappears. Breast cancer and the loss of your sex life don’t have to go hand in hand, but they often do. Next thing you know you haven’t had sex in weeks, months and maybe for a bit of time you actually forgot about it all together.
So what happened and how did things get to this point?
I see many clients, both individuals and couples dealing with many difficult things in their lives. Many of these situations revolve around trying to make sense of their sexual lives, the dissatisfaction and often discrepancy in sexual wants and needs or the absence of sex and trying to understand sex, their sexuality and personal sexual permission. When it comes to breast cancer, sex lives can and often do change and not just for the individual experiencing cancer, but for their partners too.
Cancer can cause many to feel a plethora of emotional and often physical change such as grief, anger, fear, feelings of betrayal from their body, sadness, and changes in one’s body, all of which can affect sexual functioning and create possible negative perception of one’s self-image. Additionally, there can be medication influences and changes in energy levels. The stress and trauma of cancer may cause a couple to disconnect, and/or neglect the intentional planning of time that is necessary to share, listen, and touch. The frequency of intimate and sexual activity may decrease or cease completely. When sex decreases due to desire level changes, difficulty having an orgasm, discomfort or even pain, relationship concerns or other life concerns, both individuals are affected…one issue often leads to more issues. All of these factors can and often do affect your sexual functioning and that of your partner’s. Sexual desire, arousal, lubrication, orgasm all can affect…Your Sex Life!
Here’s a common scenario: A woman learns that she has been diagnosed with breast cancer; she then undergoes a series of tests, and then treatments. With all the demands and emotional and physical ups and downs, she finds that she is less interested in sex and the “efforts” that sex require. In order to avoid conflict that arises in not wanting to have sex, she starts to move away from doing things that in the past have led to sexual activity, such as intimate kissing or touching. Then, before you know it, there is very little touching or connecting at all, which creates distance within the relationship…and no sex. The partner may feel unwanted, question their attractiveness, their sexual performance, and if they do try to initiate and are continuously turned down, there may be feelings of rejection and frustration. Eventually their sex drive may also decrease or even wane to non-existent. So now there are two sexually dissatisfied and less connected people.
So what can you and your partner do about it?
It’s important to understand how you are feeling, to be gentle with yourself and to make efforts to care for and reconnect to yourself and each other. It is important to understand how cancer has or is affecting you and your relationship, and to create self–care activities for yourself, talk with your partner, and seek counseling when needed…the earlier the better.
Steps to Help Understand and Move Through the Difficulties of Cancer
Acknowledge what has changed, acknowledge how you talk to yourself, and grieve the changes. Most importantly work to know and appreciate yourself and create time for self-exploration. For some women this may be the first time that they have given themselves permission to explore their bodies and to self-touch.
Ask yourself these questions: What do I like about my body? Do I experience pain or discomfort and how can I make adjustments? What do I need to feel in the mood to be intimate, sensual, and/or sexual? What does it take for me to have an orgasm? Where on my body do I feel good sensations, numbness and uncomfortable sensations? Are there sexual toys that I like and/or find helpful to achieve an orgasm? Do I want or need external lubrication? When do I need time to be alone?
Create Awareness:
• Discover and enjoy self-pampering activities, such as massages, manicures, pedicures, relaxing baths, aromas (candles, oils).
• Wear clothing that you feel attractive, comfortable and sexy wearing.
• Be mindful of all the pleasurable sensations that can be felt in the everyday things that you do.
• Be thoughtful of what and who you surround yourself with. Enjoy positive influences such as encouraging reading material, music, movies.
• Incorporate daily meditation and journaling
• Move when you feel the energy… deep breathing exercises, rest, stretching, and yoga, walking, biking
Talk With Your Partner
• Plan time for intimate closeness; a time for talking, touching. Discuss ways to engage in sexual and non-sexual activities that you both enjoy.
• Grieve the changes that cancer has caused with you and your partner
• Talk about any feelings of guilt. Sometimes, your partner may feel a sense of guilt when they experience their own healthy, energy and pleasures. Sometimes, you may feel guilty of the impact that cancer has caused on your relationship and roles regarding care.
• Discuss each other’s individual sexual needs and ways to meet these needs through couple sexual activity and through self- pleasuring.
Professional Help and Support
Managing through the complexities of cancer and understanding and adapting to the changes in your sexual life can often create difficulties for individuals and couples. Sexual and relationship therapy can be very helpful. Seeking support and resources early can be very beneficial for the improvement of psychological and physical well-being. Find a therapist that you and your partner (for couple’s therapy) feel comfortable with.
Things may not be the same after cancer…but with self-discovery, an open mind, and embracing and nurturing your relationship with yourself and your partner…things can continue to be intimate and sexual for you and your partner…maybe even better than before the cancer.
Her slides from the BCRC’s March 25, 2014 Educate and Empower Series: Breast Cancer and the Effects on Sexuality