It was recently, and rightly, pointed out that there is scarce information in the blogosphere about the sexual and intimacy issues that so often arise during, after, as a result of a breast cancer diagnosis and/or treatment. And even fewer places to discuss it frankly and openly. It was a point well taken.
Brenda had a post a number of months back: What Your Oncologist Doesn’t Tell You About Sex, but I’ve seen little else on the subject. And if our oncologists can’t acknowledge that breast cancer impacts our sex lives, who are we to bring it up? I mean, it’s probably just “me” that’s having an issue, right? WRONG
While I would argue that we, Americans, are fairly uptight about sex, the fact is that the group of breast cancer bloggers I’ve come to know are a pretty outspoken bunch, and seem to fear almost nothing. And yet we still don’t really talk about sex…
It is entirely possible that none of us have had any “sexual side effects” from the physical and emotional onslaught of cancer, but I don’t think so. Just for fun, please take the ANONYMOUS poll below, and let’s see just how many of us have or do feel that breast cancer effects our love life.
Talking about WHY there is so little discussion about sex and breast cancer is still not really talking about it, of course. So here goes:
There are so many areas of our sexuality impacted by a breast cancer diagnosis, and in the throes of diagnosis, decision-making and treatment, sex tends to end up as a not-so-significant priority. And I think many of us get that, as do our partners. But I would argue that something very important is lost: not just sex, but intimacy. No matter your stage, histology, prognosis, etc, the first few weeks after being diagnosed typically FEELS life-threatening. I remember being able to do little beyond sitting at the computer researching and crying. I was so consumed with this “death sentence” that I didn’t know how to reach out to my husband…either to reassure him, or to be reassured by him. This was happening to ME, not to us. And I was wrong. Yes, I know its natural and that the decisions I had to make were critical and time-sensitive. He knew that too. But the opportunity to connect with one another, to recognize that OUR lives were changing in profound ways was lost.
Treatment. During treatment I was far too sick to think about sex. But I missed the boat here too; I’m pretty sure it wasn’t about the sex for either of us; it was about intimacy, connection. I’m not saying there wasn’t intimacy, but rather than pulling away I could have been more open to letting him in closer, if for no other reason than needing the kind of support and reassurance only a partner can provide, and he probably needed that reassurance too. But being thrown into premature menopause can be overwhelming, and when you’re focused on taking the antiemetics, getting enough sleep, rearranging schedules…when getting to the market or picking up the kids is sometimes more than we can handle…it’s hard to put intimacy on the “to do” list, especially if we fail to see how much WE as patients need it!
Surgery. There is so much more wrapped up in breast surgery than we can possibly realize when we are deciding, scheduling, planning. I recall being so focused, understandably, on getting the cancer out of my body, that it was hard to realize what else is being lost, especially having had bilateral mastectomies. I was being disfigured, amputated. The part of me bound inextricably with the first signs of my journey to womanhood, with sexual pleasure, with intimacy, with nurturing my son…was diseased, deadly, and being summarily cut off. I’m not sure it was possible to foresee the impact this would have (and neither, I think, could my husband). Even after reconstruction, my breasts had gone from erotic to an on-going reminder of cancer.
Menopause. It started with treatment inducing a chemical menopause. At 35 that was hard to take. Sure, I could have been more proactive…sought advice from doctors, more medications, more interventions. But I just didn’t want to. I was tired of doctors and chemicals. So I just dealt with it. I dealt with the pain, tried to hold back the tears and, as so many women do, “do it for my husband.” Oh, and the hot flashes! Having to stop everything to cool down, at risk of losing the mood, which was often pretty darn hard to find in the first place. At least until my periods came back, and then…
Birth control. Birth control pills are often the first things to go after a breast cancer diagnosis. Last thing we need is more estrogen! IUDs contain hormones as well. And with challenges like vaginal dryness and thinning membranes thanks to chemo and drugs like tamoxifen, condoms can be problematic. Then, remember, after my periods came back, I remember being terrified that I might get pregnant and the incredible fears about the amount/impact of those hormones on my system. So unless you feel great about barrier methods or one of you is willing to have surgery, there is incredible fear and anxiety over intercourse…and that’s not really good for your sex life.
Endless challenges…my experiences alone, but I am sure there are other challenges that women experience every day. From wanting to just forget any of it happened and being utterly unable to do so, to finding it hard to be “in the mood,” to feeling inadequate, to wondering if your partner finds you “ugly,” to finding a partner if you’re single. I would bet the list is endless.
As I mentioned earlier, one of the most heartbreaking impacts of breast cancer is not just the impact on our sex lives, but the intimacy that comes with it. We are still sexual beings, and there is no reason that our sexuality should die because of breast cancer, nor should we deny ourselves other earthly pleasures because of a diagnosis. We’d never give up chocolate, right?
If you’ve blogged on the subject and I missed it, my apologies. PLEASE add your link in the comments! In general, I’d love to hear your thoughts and experiences. I think they can help everyone, if for no other reason than to know none of us are alone in this. Please consider sharing where you’ve been and what you’ve found to be helpful. Feel free to post anonymously if that is more comfortable for you, but let’s lift the sense of “shame” and start helping one another!