Navigating Intimacy and Sex After a Breast Cancer Diagnosis

BCRF investigator Dr. Ann Partridge shares common symptoms and her advice for talking with your doctor

Once she gets beyond hearing the words “You have breast cancer,” a newly diagnosed patient faces a barrage of information. “One day at a time” turns into weeks and months of treatments, scans, and follow-ups. Navigating life after breast cancer comes with its own complications.

Breast cancer therapies, though lifesaving, have both short- and long-term effects on a woman’s physical and mental wellbeing. For many women, maintaining some semblance of normalcy amidst all that may have changed—a woman’s hair, her figure, her energy level, her libido—can be as overwhelming as the diagnosis itself.

Issues around sex and intimacy should be taken seriously, says BCRF Investigator Dr. Ann Partridge, professor of medicine at Harvard Medical School and director of the Adult Survivorship Program at Dana-Farber/Brigham and Women’s Cancer Center.

“It is so important for women to be patient with themselves as they adjust in their survivorship,” Dr. Partridge said.

Here, Dr. Partridge shares common symptoms and issues, and her advice for talking with your doctor.

Talk about your symptoms

Conversations about sex and intimacy might already be uncomfortable topics to discuss with a physician. More importantly, a woman may not even associate difficulties with sex and her breast cancer treatment.

But women face a variety of issues and symptoms that can interfere with their relationships and sex lives during and after breast cancer treatment, including body image concerns (such as scars, hair loss, and loss of breasts) and changes to their sexual health and comfort (like vaginal dryness or loss of libido resulting from hormone treatments). Dr. Partridge notes that women who have been diagnosed with breast cancer feel physically, and more often, emotionally uncomfortable with the look and feel of their chest/breast area after treatment. Young women may face unique complications such as the loss of ovaries, which impacts fertility, or chemotherapy-induced premature menopause.

There are remedies for some symptoms, including loss of libido, vaginal dryness, pain during sex, and depression, which could be underlying factor in a loss of interest in sex. But your doctor needs to know what you are experiencing.

Although doctors are encouraged to ask their patients about all potential side effects of treatment, including changes in sexual intimacy, it is important to speak up about anything you are experiencing. Even if your doctor doesn’t have the answers, he/she will be able to refer you to someone who can help.

Pay attention to your mental health

According to the AACR/ASCO Survivorship Care Guidelines, 22 percent of breast cancer survivors report experiencing depression and anxiety. These conditions can negatively impact intimacy and libido.

The risk of depression is even higher in younger patients. Since symptoms of depression are not often clear, a patient and her doctor may not immediately recognize them. She may just feel that things are different and express a desire for life to return to “normal,” but may not be able to put these changes into words.

“It may be helpful to speak to a mental health provider, particularly someone who specializes in sex and intimacy after cancer,” Dr. Partridge said.

Depression can often be treated with therapy and, in some cases, medication. Be sure to tell your doctor if you’ve experienced a loss of interest or pleasure in doing things, feelings of hopeless, guilt or depression, a lack of energy, any changes in appetite, or anything out of the ordinary.

New challenges in relationships, intimacy, and sex are common after a breast cancer diagnosis and treatment. But talking about your concerns with your doctors, partners, and loved ones can help.