Real Solutions for Life's Problems

as seen in Timelesswoman.ca June 2009

Breast cancer has touched the lives of all of us - whether as a survivor or a support person for a loved one suffering through the disease. It comes as no surprise that breast cancer is the most common form of cancer among Canadian women. According to the Canadian Cancer Society an estimated 437 women will be diagnosed and an average of 104 women will die each week as a result of breast cancer. Canada has one of the highest rates of breast cancer in the western world, with one in nine women developing it in their lifetime. Despite the prevalence of this type of cancer, there is minimal research on the impacts of breast cancer on sexuality. In western cultures a woman's breasts are a source of sexuality, femininity and pleasure. When confronted with a diagnosis of breast cancer many women fear they will no longer be sexually desirable. The challenge is to reorient yourself and your intimate relationship to the reality that sex and sexuality are so much more than breasts and genitals.

As a result of the average length and prolonged after effects of treatment, breast cancer needs to be considered a chronic impairment. The vast majority (77%) of women report negative changes to their sexuality as a result of diagnosis and treatment. Most of these negative changes last at least 3 years post treatment completion. Impacts to sexuality usually begin to be noticed at the onset of treatment and include loss of libido and loss of interest in sexual expression. Depending upon the treatment received, the sexual impacts vary. Chemotherapy has the most profound impact on sexual functioning because it causes ovarian failure, leading to an abrupt menopause. Medications used to counteract the sudden menopause (e.g. Tamoxifen) cause vaginal dryness, soreness, inhibited orgasm and decreased libido. However, it is important not to forget the emotional and non-hormonal effects of breast cancer. Relational problems are inevitably exaggerated, including any pre-existing sexual issues with your partner. The general side effects of treatment, such as hair loss, changes in the skin and weight gain, lead to an overall sense of sexual undesirability. The impacts of breast cancer on sexuality are further compounded for generational women by the normal aging process that can reduce libido as well.

Studies have shown that women who become sexually inactive as a result of diagnosis or treatment are more likely to suffer from depression and are also more likely to remain sexually inactive post treatment completion. With all of this news, is there hope for women sexually after a diagnosis of breast cancer? Absolutely! When speaking with women about the impacts of cancer on their self-image and sexual expression I try and help them understand that they can turn this horrible situation into a blessing by using the opportunity to grow as a couple and as a sexual being. A partner's involvement in sexological counselling is paramount for breast cancer survivors. Remember that sex is a relationship issue, and never is there only one person that needs to change their behaviours and thoughts. Treatment includes education, incorporating the use of sexual aids (e.g. lubricants), rediscovering what sex and sexuality actually encompass, and communicating in a sex positive manner about expectations and fantasies. Although women do not often think about the impacts of cancer on their sexuality until after treatment completion, it is important not to let the changes negatively impact you for long. With assistance, you can become a better, more confident sexual being. The first step is to reach out for help...