Let's Talk about Sex (or Not): Vaginal Atrophy and Loss of Libido

 

“I don’t look sexy”, and “I don’t feel sexy”. “Surgery has left scars” “I don’t feel confident about my body”. “I am exhausted”.

 

Here at BRiC, we tackle the most painful and sensitive aspects of our experience of primary and secondary breast cancer. The impact of breast cancer on sexuality and sexual health is a taboo subject for many women, however, we try to introduce interesting and honest discussions about how our sex lives have been affected by surgery and treatments. 

 

    Many of us feel, after surgery, that we are ugly and deformed, with our scars and lop-sidedness, or maybe no breasts at all. The effects of chemotherapy and hormonal treatments stripping off estrogen from our body means that intimacy is difficult. Dryness causes intercourse to be painful, if possible at all, and lack of libido only adds to our problems. This means we are not confident and this dampens our ability to relax and be close. We talked about how some creams may help with vaginal dryness and pain but when our drive is inhibited, the spontaneity and pleasure is almost gone. For some, physical intimacy is loaded with fear, with rejection, and disability.  We can’t deny that breast cancer fundamentally changes us, mind and body. 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.

 

    “I don’t know where my libido is?” “I used to be sexual and have a full-on fiery sex life before breast cancer, but that has all gone now” “Sex? It’s all in the past.”

 

For those of us in search for a new partner it also takes its toll:

“I’m not sure I’m going to find anyone who would put up with this”, “It is difficult to explain.”

 

    We agreed that with time we could feel more confident about our body image and intimate relationships, but we will never be the same and we grieve for our old selves.  The mental scars of breast cancer diagnosis and treatment run deep, they plague our self-esteem and disrupt our basic healthy desires. Many of us still struggle to understand who we are as a result of these traumatic changes. From the outside, we seem to be coping well, and moving ahead, but from the inside, it's another story. A story less told.

    

    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 fall apart inside. So many of us who had enjoyed sex pre-diagnosis found our womanhood stripped from us by cancer. There may also be the expectation for a return to normal, only to find loss.

    

“We have come to terms with it, that sex is something of the past.” “I think that he will probably leave because of this” “He is understanding but I do worry” “I try and explain but it was so long ago that he is convinced it’s psychological”.

    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.

“It is so painful that I try and put it off” “I cry after having sex” “The creams and lubricants are OK but don’t make me feel sexy” “It is impossible at times.”

    It was encouraging to hear that satisfying sexual activity was experienced by a few of us. Trust, communication and sharing vulnerability and experiencing intimacy in new ways had helped. But the few of us who shared success stories were hugely outnumbered by those with ongoing difficulties.  Talking about all of the above helped us all to realise we are not alone, and it was helpful to share tips and experiences, but it highlighted a real need for more support in this area from the outset.