Let’s talk about sex
TIPS TO HELP COUPLES REDISCOVER THE JOYS OF INTIMACY DURING BREAST CANCER TREATMENT
Health experts are using this Breast Cancer Awareness Month to shine a spotlight on some of the less-talkedabout challenges women face during treatment – including changes to romantic intimacy.
They aim to break the taboo of talking about sex and help women and their partners find solutions that improve quality of life.
University of Sydney professor of cancer nursing Kate White says intimacy issues among breast cancer patients are “more common than people generally feel comfortable to be known”.
“We know that 90 per cent of women diagnosed will identify this part of their life as important to them, and 75 per cent report changes in intimacy, the ability to maintain relationships, sexuality and sexual function,” she says.
White, who presented on this topic for Breast Cancer Trials’ expert series, available at breastcancertrials.org.au, says there is both a physical and psychological element.
“Not everyone has a mastectomy so it’s not just about losing a breast,” she says.
“It’s that something has come along and changed them and makes them feel different about themselves.
“It may be the surgery and having the scar; a portion may need to have chemotherapy and they lose their hair for a period of time; (or) things they might have felt pleasurable can no longer feel pleasant – things like nipple stimulation.”
White says a breast cancer diagnosis and treatment can also affect husbands and partners, who take on a new role in the relationship.
“If the woman is unwell … they move from being intimate partners to being a carer or supporter,” she says. “Unless you focus on the emotional intimacy, it is hard to get that relationship back to being a couple.”
White advises couples to be willing to experiment in the bedroom if things that previously felt pleasurable no longer do.
She also recommends putting aside the time and space for sex in case it takes longer to get in the mood. “We know there are some physical changes that can make it a little bit harder for women to feel sexy and be physically intimate,” she says. “Fatigue can also be a problem after chemotherapy so at the end of the day if their partner was to reach out they might not have the energy, so we encourage couples to look at other times of the day.”
GO ON DATES
Do social things together, hold hands, go for a walk, advises White.
“One thing that helps post treatment is physical activity,” she
says. Even socialising with good friends over dinner gets endorphins coming in. Go out to dinner, have a wine, come home and have sex.”
TALK ABOUT IT
White recommends women ask their partner how they are feeling.
“Go for walk and say, ‘The last few months have been rough for me, what has it been like for you?’ or ‘I notice our romantic relationship has changed, is that something that is concerning you?’” she says. “It can be that he is not making overtures (because he doesn’t want to add pressure) and she is not, and they are both thinking the other is not interested.”
Partners often go to extra lengths to show they are still physically attracted but don’t always have the right words, according to White.
“One of the biggest challenges is that partners seek to reassure when a woman says ‘I feel different and unattractive’,” she says. “They say, ‘Of course I am still attracted, you are more than your boobs’, but that’s actually dismissing the woman’s concerns and not hearing them.”
BE WELL INFORMED
Some hormonal treatments have physical side effects, such as decreased libido and vaginal dryness that makes sex uncomfortable.
“Understand that loss of libido doesn’t mean it’s completely gone out the door,” White says. “It may take a woman longer to become aroused and partners need to understand that.” White recommends buying a quality water-based lubricant and vaginal moisturiser.
DON’T SUFFER IN SILENCE
“Talk to a breast nurse a good GP or a women’s health practitioner,” White says. “If (intimacy) is a concern, it’s really valid and understandable and with the right information there are significant things we can do to help.” The 2022 Australian Women’s Health Diary is now on sale at breastcancertrials.org.au with proceeds directly supporting breast cancer research