Sexuality & Breast Cancer: How to Reclaim your Mojo

Let’s talk about sex, baby – Let’s talk about you and me
Let’s talk about all the good things – and the bad things – that may be
Let’s talk about sex

Salt ‘n’ Pepa lyrics filled my head recently as I prepared to moderate a panel discussion on Body Image, Sexuality & Breast Cancer following a performance of Maja Ardal’s play HER2 by Nightwood Theatre. I was joined by a panel of brave, brilliant women who shared their perspective on the subject from their experiences as a PhD candidate in Clinical Psychology (with a focus on sexuality in respect to female cancers), a Sex Educator, and a young woman who experienced breast cancer at the young age of 28. Here are some reflections from this provocative topic discussion.

Sexuality encompasses a wide range of feelings, desires, and preferences. Body image plays a major role in our sexual health, and is shaped by a variety of factors. Bottom line? It’s complicated and incredibly personal. A breast cancer diagnosis and its treatment further complicate matters, especially for young women in the prime of their sexual lives. Sex is not often at the forefront of medical discussions while in treatment –there is no shortage of “issues” to deal with during this time – yet maintaining intimacy is critical to quality of life.

Even outside of the context of cancer, it is evident that many women experience issues with body image & sexuality. Our panelists lamented the fact that little study has been done on this issue, but that “most” women they encountered had concerns to some degree. I polled the audience to see how many had experienced issues around body image and sexuality and those bold folks pretty much unanimously raised their hands.

Panelist Kim Sedgwick of Red Tent Sisters stated: “Navigating sexuality and breast cancer has its own unique physical and emotional challenges, but many of them are extensions of issues we all face.”

So why do we avoid talking about sex? It’s in our face all the time. We live in an incredibly sex-saturated society – but candid personal conversations are comparatively rare. Perhaps it is because “good girls don’t kiss and tell”? There is still a lot of shame and stigma attached to sexuality. Or maybe it is because the depictions we see of sex are so narrow that we aren’t inspired to explore our unique interests. Moreover, sex is an area of our lives that can be incredibly emotional – even traumatic. We may want to improve our sex lives, but it takes persistent work – so we put off the conversation until it becomes too big and portentous, silencing our need for satisfaction.

Over 65% of young women with breast cancer are concerned with loss of libido as a major side effect of treatment.*

There are numerous physical and emotional challenges resulting from breast cancer and its treatment that can affect sexual ability and desire. The shock and uncertainty of an initial diagnosis alone may leave intimate encounters on the back burner. Surgeries and radiation bring about drastic bodily changes and scars and can affect the skin’s sensitivity. Chemotherapy brings various side effects from hair loss to body pain & discomforts to fatigue and depression/anxiety. Vaginal dryness can make intercourse painful, and sore, dry skin can make you feel untouchable. Many treatments lead to suppression of ovarian function and/or early menopause, disrupting the hormone balance and upsetting the delicate interplay between the fertility cycle and libido. Infertility affects some women as a side-effect of treatment, which can cause further stress on relationships and sex as there are often feelings of guilt, insecurity and loss that detract from focusing on bodily pleasure. Overwhelming situations and additional medications can cause unpredictable mood swings. The list goes on.

It is hard to feel sexy when your sexual organs feel like they’re under specific attack – and the whole journey can have a devastating effect on body image.

Many people continue to have an active sex life during chemotherapy, or things return to normal soon afterwards. But sometimes this isn’t the case. Body memory following trauma can be painful – it is difficult to break a cycle of painful intercourse, and you may need some redirection as you heal. How do you communicate about body changes to your partner as you are entering into more intimate territory? Is it possible to reframe your inhibitions to focus on what you can do to connect and be more intimate? Embracing the available options can lead to more confidence as you discover your “new normal” in the bedroom.

The experts on our panel shared some specific strategies that you can use to help with sexual connection following bodily trauma:

  • Take intercourse, or certain body parts, off the table. Don’t try to “force it” in areas that are painful or where there are lingering body image issues. Part of finding your new normal is the adventure of discovery. Things that used to feel good may not anymore, but it can be fun to find out what DOES feel good. Spend some intimate time with your partner exploring – the mouth, ears, neck, shoulders, back, knees and feet are erogenous zones that are particularly sensitive to being touched – especially when you have made a conscious choice to take off the pressure of intercourse.
  • Experiment with both spontaneous and scheduled intimate time. Try to be receptive to in-the-moment displays of affection, but also set aside specific times for exploration so that you can be prepared and even start to get excited with the anticipation of these encounters.
  • Watch an erotic movie. There are some empowering female directors out there making erotic films that can give you ideas for exploring intimacy. Still intimidated? Start by snuggling up a little closer with your lover the next time a sexy scene in a feature film turns you on.
  • Visit a sex store that takes a sex-positive approach to sexual pleasure, health, and education. Come As You Are and Good For Her are good examples in Toronto, but most cities have them. Go alone to discover what tickles your fancy, or bring your partner to open up some playful communication. Vibrators and lubricants can help with vaginal dryness, and many shops offer educational workshops.
  • Investigate the available services & programs in your city! Panelist Kim Cullen developed and facilitates an online intervention for couples facing breast cancer, and Kim Sedgwick co-founded Red Tent Sisters with her sister Amy, which offers workshops and coaching as well as a pretty amazing blog.

How can partners help? Openness and communication are key. Partners can take the pressure off by taking the initiative and opening up gentle lines of communication without judgment. Let your partner know that you still find them beautiful and desirable. Rev up the romance with intimate touch, without expectation. Snuggle more: skin-on-skin is generally full of oxytocin goodness. Go slow and pay attention.

*In 2013, Rethink Breast Cancer commissioned Canada’s first-ever qualitative Needs Assessment survey about the young women’s breast cancer experience, from diagnosis through treatment and post-treatment. This survey showed that younger women generally had more aggressive treatments and higher levels of stress when compared to older women, and that relationship issues were top of mind. Check out the report for more stats and insight into young women and breast cancer. – Jen Lagzdins

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