Saturday, 8 December 2018

Weekly Discussion Summary ~ Impact on sexuality and sexual health

The impact of breast cancer on sexuality and sexual health is a taboo subject for many women.

Here at BRiC, we tackle the most painful and sensitive aspects of our experience of primary and secondary breast cancer. In this week’s discussion, we shared how our sex lives have been affected by breast cancer, for the most part in painful ways. 

For many of us, this was the first time we had shared our feelings and it became clear that a huge number of us are suffering in silence and have no idea where to turn for help.

Breast cancer fundamentally changes us, mind and body. We may lose our breast or breasts, we have scars, we may be unsymmetrical, we may have chosen or have been unable to have reconstruction. For many, breasts are powerfully associated with womanhood and sexuality. Is it any wonder that our sense of ourselves as sexual beings is profoundly altered?

Our confidence and enjoyment of our bodies is shattered by brutal treatments like radiotherapy and chemotherapy, but we also contend with early, severe and prolonged menopausal symptoms as a result of hormonal treatment. These effects often worsen and are impacting us years after the end of so-called active treatment - many of us shared that we experienced a loss of libido, others talked about vaginal dryness which can make intercourse painful. Some of us shared that intimacy is the time when we most miss our breasts, maybe we miss the sensations we used to experience, maybe we miss our previous abandon, maybe we feel inhibited or undesirable as a result of our weight gain. Though our individual concerns varied, our feelings were startlingly similar:

Some of us fear intimacy, we avoid it.
Some of us crave closeness and intimacy but are afraid to initiate it.
Some of us feel single even when we are in what appear on the outside to be ‘happy’ relationships.
Some of us are single and fear having to build a relationship with a new partner and so we choose to remain on our own. 
Some of our partners have walked away from us, leaving us abandoned and alone. 
A few of us experience strong sexual feelings which our partners do not seem to reciprocate.

Very few of us had received any medical or psychological support for these issues. Sex is not mentioned or talked about when we ask about the side effects of treatment. No help is offered. 

We often have no one to confide in and we especially don’t want to talk to our partners - we fear their responses or rejection. We may drift into a sexless relationship, trying to pretend to ourselves that it doesn't matter while we silently die inside. So many of us who had enjoyed sex pre-diagnosis found our womanhood stripped from us by cancer.  

We worry that without sex, our partners may seek it elsewhere. Some of us have sex for our partner's sake but we don't enjoy it. For some, our partners are our carers and are no longer our lovers. Then, comes the expectation for a return to normal only to find loss.

Satisfying sexual activity was experienced by a few of us. We shared that trust, communication and sharing vulnerability and experiencing intimacy in new ways had helped. But the few of us who shared our success stories were hugely outnumbered by those with ongoing difficulties.

What can we do?

Breast Cancer Care have produced a good leaflet about sex and breast cancer treatment https://www.breastcancercare.org.uk/…/sex-breast-cancer-tre…


This blog by the breast surgeon Liz O’Riordan, herself diagnosed with breast cancer, also offers lots of advice 
http://liz.oriordan.co.uk/BreastCancerBlog_files/lets-talk-about-sex.html

Her suggestion is to have a “box of tricks” including a good lubricant. Some are available on prescription so we don’t need to pay for them. 

YES is a highly recommended water-based product which can be used as an internal moisturiser to help relieve dryness and irritation and works better than silicone-based lubricants. 

Another popular product is SYLK. 

We also know that coconut oil or Vitamin E oil can be helpful. 

A small vibrator can help with feeling dry and tight and it can be worth considering dilators which can help make sex less painful.

In her blog, Liz O’Riordan explains that oncology appears to be reviewing its position about the use of topical vaginal oestrogen for breast cancer patients - available for women who experience this symptom as part of their menopause - she says that one school of thought was that if women used them, the tiny amount of oestrogen that they would absorb might increase the risk of the cancer coming back. However, small trials have shown no obvious increase risk in recurrence for women taking Tamoxifen. This is important because it is a very effective treatment and some of our members shared that this had transformed their quality of life. It must be a decision made by each woman and her doctors based on her individual situation.

A good shop that comes highly recommended by a psychosexual counsellor is: 

“Sh! is a sex shop truly worth shouting about. When it opened in 1992, Sh! was the first ever ‘women only’ erotic boutique, designed to give ladies a welcoming, safe place to shop for intimate items and get sound sexual advice.”

If you are a woman living in the UK with a breast cancer diagnosis and you would like to join our private group, please send us a message via our Public Facebook Page.



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