1. Loss of sexual desire
Many people being treated for breast cancer find their desire for sexual contact decreases.
This could be because of:
- Side effects of treatment
- Fatigue
- Changes to your body and confidence about how you look
- Being unable to concentrate on anything other than your diagnosis and treatment
You may want to maintain a level of closeness with your partner even if your sexual activity has decreased or stopped completely.
You may be happy holding hands, hugging, kissing or finding your own ways of being intimate.
Sexual activity can also include touch and other signs of affection that don’t always lead to oral or full sex but still result in pleasure.
Loss of desire can continue for many months after treatment, but as time moves on this should start to improve.
2. Getting back to sex
You might be anxious about your first sexual experience following your diagnosis, or worried things will not be the same as before. All these feelings are normal.
It may take time for your confidence to return and for you to feel comfortable being intimate with a partner or having sex again.
When you feel ready to resume or increase sexual activity, you may want to make some time specifically for you and your partner, free from distractions.
Tips for getting back to sex
Start afresh
Try not to compare things to how they were before you were diagnosed with breast cancer.
Finding new ways of being intimate with your partner may help you to adjust and adapt to the physical and emotional changes that have happened. It may also make you feel more comfortable about intimacy.
The effects of your treatment may mean you need to think about trying different sexual positions. This might be because of pain or discomfort due to treatment or surgery, or because you don’t want the focus to be on a particular part of your body.
Use lubricants or moisturisers
Using a vaginal moisturiser on a regular basis, and a vaginal lubricant during sexual activity, will help improve vaginal dryness and help prevent pain.
Explore your body alone and with a partner
It can be useful to explore your body on your own first. You may wish to use your fingers or a vibrator. This can help you discover what kind of touch is pleasant. You may find using a vaginal lubricant helpful.
Sensual and genital touching, with a partner and on your own, can help remove anxiety associated with sex and can be a helpful starting point for people resuming sexual activity.
If you have a partner, you can share your discoveries with them to make sex as fulfilling as possible.
If you’re masturbating with your partner, start slowly and without any expectations. If you want to use a lubricant, it might help to discuss this beforehand.
Non-sexual cuddling, taking gradual steps, and relearning how to give each other pleasure can help you feel more comfortable.
Pelvic floor exercises
Doing pelvic floor exercises increase blood flow to the vaginal area. This can heighten sexual feelings and help relax these muscles.
Don’t rush
Taking things slowly at first may help. Think about what kind or level of intimacy you feel comfortable with and how much energy you have.
There may be practical things to consider, such as taking pain relief for any ongoing post-surgery or treatment pain.
Create a relaxed atmosphere
Creating the right mood may help you relax and increase your confidence. Lighting, music or aromatherapy oils can help create a comfortable and sensual atmosphere.
Wear what makes you comfortable
Some people may feel uncomfortable naked and choose to wear nightwear. Others wear a prosthesis and bra to bed. It’s important to wear whatever makes you feel more comfortable and relaxed, even if this makes intimacy or sex less spontaneous.
Changes to your breasts after treatment
Changes to, or removal of, a breast through surgery and radiotherapy may have a big impact on your sexual satisfaction, especially if having your breasts stimulated was an important part of your sex life.
How you feel about having your breasts touched after treatment is very personal.
You may want your partner to touch the area that was treated, or you may not want any touching at all. Some people don’t want their partner to touch the breast that wasn’t treated if it reminds them of the loss of the other one.
How you feel about having your breasts touched may change over time.
It may be helpful to tell your partner what sort of touching you want or don’t want. If you find talking about it embarrassing, it can be easier to use your hand to guide them.
You and your partner may also want to focus on other areas of your body to help you feel sexually satisfied. Some people find sex toys, such as vibrators and clitoral stimulators, helpful in finding out more about what gives pleasure (see the tips above).
Find out more about changes to your body after breast cancer treatment.
3. How your partner may react
If you had a partner when you were diagnosed, they will also face a time of readjustment.
How your partner responds to you sexually may be influenced by how they reacted to your breast cancer diagnosis.
While some people’s sex lives may continue much as before, some partners may take on an overly protective role. This means they may try to do everything for you and protect you from any further distress. They may not want to mention or initiate sex for fear of upsetting or hurting you.
Some partners need time to accept what’s happened. Others cannot come to terms with their partner’s breast cancer and may distance themselves.
Try talking to your partner about how you feel. This might encourage them to share their own thoughts and concerns. You may find you’re making assumptions about how the other feels without realising it.
Tips for talking to your partner
- While it may be difficult at first, try to be open and honest about how you are feeling and what you both now expect from sex and intimacy. This can avoid mixed signals and can make your partner aware of your limits
- Talk when you’re not being intimate, so you don’t feel awkward or interrupted during those times
- Talk about the things you’ve been enjoying as well as those you’ve found difficult. This can help you both to feel encouraged and relaxed
- If there are aspects of intimacy that you feel uncomfortable discussing in person, try emailing or texting instead
- Keep talking to each other to make sure you are clear about any boundaries and have the same expectations
Your partner may also find it helpful to read our My partner has breast cancer and How to support someone with breast cancer information.
4. Changes to your relationship
You may find that an existing relationship changes after you’ve been diagnosed with breast cancer. Some couples become closer and their relationship gets stronger. However, a relationship can become strained.
A cancer diagnosis and treatment might mean you and your partner adopt different roles in the relationship compared to before. This can be difficult to cope with.
Your or your partner’s perspective may change, and you both might focus on new priorities and re-evaluate your responsibilities and what is important.
This may lead to the relationship coming to its natural end.
Being able to talk openly about your situation can mean you’re able to find solutions together. This may be a gradual process, but avoiding problems altogether may make them more difficult to resolve in the long run.
Dealing with something like cancer can change a relationship. This may be particularly difficult if the relationship is new. If you’re in the early stages of a relationship, you may find you’re discussing important issues much sooner than you would have liked.
5. Starting a new relationship after breast cancer
You may find the thought of forming a new relationship daunting.
Meeting someone new may mean telling them about your breast cancer. Deciding when and how to do this can be difficult.
You may feel there isn’t a right time to talk about this, or you might be unable to find the words you want to use. But as you get to know someone and feel more comfortable with them, you may find it easier to talk about all aspects of your life, including your breast cancer.
When you feel the time is right to tell your new partner, they may respond in a few ways. They may initially be shocked and take a little time to adjust to this news. They may have their own anxieties and fears around cancer and what it means to them. Or your new partner may be very accepting of your history and recognise that your experience of breast cancer is now part of who you are.
You will both decide on the right time to be intimate. If you’re feeling anxious about this, talk to your partner about your concerns and the specific things you’re worried about.
6. Emotional effects of breast cancer on intimate relationships
The emotional effects of breast cancer and its treatments can affect sex, intimacy and your relationships.
The following information outlines how anxiety, worries about sex, or low mood and depression might affect your sex life, and includes tips on what might help.
Anxiety and worries about sex
It’s normal to have anxiety when you have breast cancer. Anxiety may be only short-term, or it may continue for some time after your treatment is over.
If you’re worried about your treatment or the future, you may find it difficult to relax enough to think about or enjoy sex.
Tension and anxiety can also reduce a person’s ability to become aroused and reach orgasm, so you and your partner may want to explore techniques that help you both relax.
You may worry about initiating physical intimacy, be concerned about how your partner feels, or feel uncertain of how to approach new relationships.
All these feelings are normal, and it may take time before they lessen or disappear completely.
Talking to your sexual partner about how you feel might ease some of these worries. Some people find it helpful to talk to someone close to them about the concerns they have.
However, it can sometimes be hard to talk to your partner or family and friends. You may find it useful to speak to your breast care nurse or treatment team. They may refer you to a specialist counsellor to talk through your concerns.
Low mood and depression
Having low mood or being depressed can mean you lose interest in sex or find it less pleasurable.
If your symptoms of depression continue, you may need to seek specialist help.
Your treatment team or your GP can talk you through the options for treating depression.
Counselling, talking therapies and drug treatments can all be effective in treating depression. However, some anti-depressant drugs can reduce sexual desire and may make reaching orgasm more difficult.
7. Help if you need it
It may help to talk to your treatment team, breast care nurse or GP if you have any concerns about how you feel about your body or sex life.
Even if it’s been a while since you finished your treatment, your breast care nurse will still be a useful point of contact. They may be able to help with any questions you might have – for example, if you want to know how to cope with vaginal dryness or if you’re concerned about menopausal symptoms.
You can also call our helpline to talk through your feelings and concerns with one of our nurses.
Sometimes you may need specialist help. This may mean you, or you and your partner, seeing a counsellor or a therapist who deals specifically with sexual issues. Your GP or breast care nurse should be able to help arrange this for you.
Alternatively you can contact an organisation such as COSRT (College of Sexual and Relationship Therapists), RELATE or IPM (Institute of Psychosexual Medicine).
Most people with breast cancer who have sexual problems don’t need long-term therapy. But you may find it useful to talk to someone about a particular problem or at a particular point in your treatment or recovery.
Talking about changes to your body, sex and intimacy can be difficult. But addressing your concerns is an important part of your breast cancer treatment and care.
Our Your body, intimacy and sex booklet contains a prompt list that is designed to help you discuss these issues with a healthcare professional or when calling our helpline.
