Many women report a loss of libido after breast cancer treatment. There are simple solutions that can help.

Chemotherapy, hormone therapy and breast surgery all have an impact on sexuality, with symptoms from vaginal dryness and tiredness to the loss of libido. There are solutions, sometimes simple ones, for these problems.

 

When desire disappears

 

Possible causes:

• Pain – from surgical scars or infection
• Chronic fatigue (extreme, prolonged tiredness)
• Fears, worries, general malaise from the disease
• Feeling less attractive as a result of surgery
• Some chemotherapy and hormone therapies reduce oestrogen and testosterone levels, and may decrease libido

 

What can help:

• Share your thoughts with your partner – about your current lack of desire, but also about your wishes and needs. Ask your partner what they would like.
• Techniques such as meditation and yoga can help you relax.
• Develop erotic fantasies – alone or together.
• Hugging and massage. Mutual touching can help you relax, sexually stimulate you physically and emotionally, and bring you closer to your partner.
• Some women find that masturbation helps. In this way, you can rediscover your body without pressure, at your own pace.

 

When you have vaginal dryness

 

Possible causes:

• Oestrogen deficiency due to hormone therapy
• Lack of sexual desire
• Surgery and/or radiotherapy in the pelvic area

 

What can help:

• Vaginal lubricants and moisturisers
• Oestrogen applied directly to the vaginal area as a pessary or cream. This promotes the circulation in the vaginal tissue and relieves dryness of the mucous membrane. Unlike lubricants, which are used only when having sex, it is usually applied regularly 1-3 times a week. As a small amount of oestrogen is absorbed into the body it is not recommended for everyone – ask your doctor or breast care nurse if this would be suitable for you.

 

When you have itching or a burning sensation in the vagina

 

Possible causes:

• Radiation to the pelvic area
• Chemotherapy
• Hormonal changes that upset the vaginal environment

 

What can help:

• Wearing lingerie made from natural fabrics such as cotton or silk rather than synthetic materials reduces the risk of infection.
• Loose-fitting garments are less irritating than tight underwear or thongs.
• Wash your genital area with water only. Soaps and lotions can interfere with the balance of bacteria and pH levels in the vagina.
• If you think you have an infection, speak to your doctor.

 

When you have pain during sex

 

Possible causes:

• Surgical scars.
• Vaginal dryness or infection (see above).
• Vaginismus (spasm of the vagina) – because of anxiety or emotional stress.

 

What can help:

• Talk to your doctor to find out what is causing the pain.
• Gentle massage can help scar pain. Use an unperfumed cream or oil.
• Stretching and relaxation exercises increase physical well-being. Avoid jerky movements when the scars are still fresh.
• Finding the right position can help prevent pain during sex. For example: 1) Lying next to your partner avoids pressure on the operated breast. 2) Sitting astride your partner can help you control the intensity and rhythm of the movements.
• If your fears aren’t getting less over time, talking to a sex therapist can help.
• Give yourself time to recover after surgery and don’t put pressure on yourself.

 

When the tiredness doesn’t go away

 

Possible causes:

• Chronic fatigue – extreme tiredness is a common side effect of cancer treatment
• Anaemia

 

What can help:

• Talk to your doctor and identify the cause of the tiredness.
• Stay active. Although it may sound strange, physical activity can reduce fatigue. Accepting that this exhaustion is normal after treatment can also help.

 

When your body has changed

 

Possible causes:

• Surgical scars
• Breast conserving surgery/lumpectomy (asymmetry)
• Reconstruction
• Mastectomy

 

What can help:

• Share your worries with your partner. Remember: sexual attraction is not just based on external factors – discuss your feelings about your scars or missing breast with each other.
• Get to know each other again, with hugging or mutual massages, for example.
• Create an atmosphere with low lighting.
• Pretty lingerie or a breast form can help support your confidence.
• Relaxation techniques, exercise or dancing can help you get comfortable with your body again.
• It often helps to share your experiences with others who are going through the same thing.

 

Disclaimer
The type, course and treatment of breast cancer vary from woman to woman, and everyone reacts individually. We strive to provide you with comprehensive, factually correct and understandable medical information. However, this cannot replace consultation with or treatment by a doctor or medical practitioner. The information we provide can help you prepare for a doctor’s visit and supplement the information they give you.