Let’s Talk About Sex

As clinicians, we find the majority of our patients will experience side effects from their cancer treatment, including a disruption in their sex life. In fact, many say it comes to a screeching halt. They feel their focus should be on beating cancer, not on sex and intimacy, so they don’t even bring up the subject. During The Breast of Everything podcast, Comprehensive Breast Care surgeons Linsey Gold, DO; and Ashley Richardson, DO; talk candidly and openly on this topic with expert Rachel Needle, PsyD, a licensed psychologist and certified sex therapist. Women in general aren’t comfortable talking about sex, and breast cancer patients just assume sex will not happen while they are undergoing treatment. Sex is the overlooked elephant in the room; patients don’t talk about it and many doctors often don’t open the door for a discussion.

It is okay to talk about it; in fact, it should be discussed. A woman should be talking about how she is feeling on the inside as well as the outside. First, it is okay to have sex. Some women may lose their sex drive from the time of diagnosis through treatment and even long after treatment. About 50 percent of women who have had breast cancer treatment experience long-term sexual dysfunction, and 40 percent to 100 percent of these dysfunctions are related to how a woman feels about her body. Breast cancer treatment can cause premature menopause, vaginal atrophy, fatigue and depression as well as self-image issues – all impacting a woman’s sex drive. At least 70 percent of women will experience depression during and after treatment. Women think, “I’m lucky to be alive, I shouldn’t be wanting to have sex,” however, we are sexual beings!

We cannot ignore this. We can remain sexual in our own ways.Your body is changing and your relationship with your partner also may change. Women worry … “will he still want me?” Studies show that if you had a positive sexual relationship prior to your cancer diagnosis, you will continue to have a positive sexual relationship.Being informed of what to expect is critical. A patient’s physician is there to provide education, information, support and encouragement. If you are not comfortable talking with your physician, find a certified sex therapist who has the training and knowledge to help you.So, how do you restore sexuality after cancer?First, make sure both partners are on the same page.

Communicate. Talk about what you like and don’t like and what makes you uncomfortable. You can begin with non-sexual touching, or experiment with different positions. You may have to change your usual ones.Women may lose nipple sensation, especially those who had plastic surgery following a mastectomy. The nipple does not retain its function or feeling.

Most important: start the conversation! Redefining sex can be empowering. Rethinking your concept of intimacy can be healing. Dr. Needle is the Executive Director of Whole Health Psychological Center and the Co-Director of Modern Sex Therapy Institutes, an organization that provides continuing education and certifications in sex therapy, LGBTQIA affirmative therapy, and much more. You can visit DrRachel.com.

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