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How to Regain Sexual Health and Intimacy After Breast Cancer

CoupleHugging_300Sex may be the last thing on your mind after a breast cancer diagnosis, but it can make you feel loved and supported as you endure cancer treatments and live life beyond being a breast cancer patient, says Dede Bonner, Ph.D., author of The 10 Best Questions for Surviving Breast Cancer: The Script You Need to Take Control of Your Health.

Some sex experts say that your most potent—and most underutilized—sex tool is your voice. Asking each other these Best Questions, along with your own personal questions, will get you started on rekindling sexual desire. You’ll learn how your partner feels, what he or she wants, and how to make each other happy.

1. How can we best communicate with each other about our needs for sex and intimacy?
Women tend to romanticize sex and intimacy, while men are more likely to have a body-centered or recreational approach to sexual encounters. These natural differences between men and women explain why talking about sex and intimacy can be tricky. In their book Intimacy after Cancer: A Woman’s Guide, Sally Kydd and Dana Rowett comment, “Men don’t ask for directions and don’t read instructions… even for sex. Just show us the parts, and we’ll put it together.”

Your best communications on sex might be using no words at all. Perhaps having some signals or a couple of phrases can serve as “code” for when one of you is feeling amorous. Working out your personal preferences and communication styles in advance can help smooth out misunderstandings and clarify expectations.

2. Are you comfortable being intimate again?
It’s possible that nothing can prepare either of you for the shock of what your chest looks like after surgery. Examine and touch the scars together to help you both adjust to the physical changes. Scars will heal over time and become less red and raw looking. If you engage in sex, the partner may fear hurting the patient during lovemaking. Talk with the patient about the sexual positions that are the most comfortable for her. The partner should also ask the patient about possible pain caused by vaginal dryness after chemotherapy or hormonal changes.

3. How can we redefine and restart our intimacy and sexual pleasure again?
Let’s face it. A cancer journey is a long, hard haul for both of you. Chemotherapy is a drag, and so are radiation therapy and hormonal therapy. The patient is tired, stressed out, and may be suffering from side effects like nausea, pain, or lymphedema.

Even though the partner understands this at one level, it’s also quite common for the partner to still feel rejected, resentful, and drained from his or her caregiving demands. Here are some suggestions for things to try from experts in cancer and sexuality:

—Enjoy a romantic candlelit dinner.
—Offer a long sensual massage.
—Watch an erotic video together.
—Try new sexual positions.
—Book a romantic vacation or quick get-away trip.

4. For the partner to ask: What do you want to tell me about the physical changes in your body?
This is a very direct question about a topic many couples avoid discussing. Women may hesitate to share their pain or feelings about their new appearance, fearing they will alienate their partners. Male partners may be reluctant to discuss the woman’s physical changes because it’s a constant reminder of how powerless they have been to “fix the cancer,” a nearly universal male reaction.

5. What can I do to please you?
Become dedicated to recapturing mutual pleasure for you and your partner. Sex is fun and pleasure is good medicine for the patient—and for your relationship.

6. What’s the craziest or funniest thing we could do to show our love for each other?
Rediscover your passion by having fun together. Go from boring or scared to blissful in the bedroom. Be creative with your passion and direct it toward your partner with a renewed fire. Nurture it. Enjoy and revel in it. You are alive.

7. Is there anything off-limits now that was okay before?
If you don’t ask each other this question, your unspoken assumptions about what’s acceptable and what isn’t can lead to major misunderstandings. Be clear about your limits and nonjudgmental about your partner’s desires. Talk this question out without criticism or bringing up your past sexual or marital problems.

8. We agree we both have a low interest in sex right now. What can we do to get back on track?
This Best Question is for circumstances when you both have a low sex drive and agree that this is a shared situation. You may end up agreeing that neither of you wants to resume sexual relations for a while. This might be your new definition of “back on track,” but at least you’ve made sure you both agree with it.

9. We can’t agree about having sexual relations or being intimate. How can we work it out?
Keep in mind that even if your sexual desire is reduced or absent it’s still possible to be a good lover. During this time, you still can be physically intimate without sexual intercourse through kissing, touching, stroking, cuddling, hugging, massaging, or sharing loving words.

10. Do we need professional help?
Sexual problems create emotional problems and vice versa. You may want to talk to a professional therapist or counselor, ideally as a couple. There are many professionally trained specialists who deal with intimacy and sexuality issues for cancer patients and their partners. Ask an oncology social worker or a nurse navigator for a referral. Some large cancer care centers have specialists connected to their facility.


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