Life after a cancer diagnosis is scary. Many women who have been diagnosed with breast cancer fight hard, only to face some disappointments on the other side of the battle. I have seen many patients in my practice who – after the surgery, chemotherapy and radiation or other medications – face frustrations that come along with surviving. One patient told me her elation over living through breast cancer treatment was deflated by her disappointment in the bedroom.
Intimacy after you have been through a mastectomy is different. A woman’s response to her body’s changes will be as unique as the woman herself. Some of my patients have been happy to have new breasts, as they were unhappy with their look before. Some are devastated and view the prosthetics as foreign objects they don’t even want to look at. If a woman is sexually active, she may face other challenges. The nipples, which were once sensitive and a part of her sexual response, now have no or little feeling, or she may not have nipples at all.
The vaginal tissues also have a response to chemotherapy, as the hormonal signals are interfered with, and she begins to have problems that were never there before therapy. Vaginal dryness, and in turn discomfort with intercourse, is a common complaint in women on tamoxifen or other agents used in patients with breast cancer. There is often a misunderstanding among those patients, or just lack of information, about what can be done to alleviate symptoms. Some women notice a decline in sex drive. This can be due to some of the therapies combined with the challenge of accepting the differences in their body. Difficulty achieving climax can also play a role in decreased sex drive.
There are treatments available to women are willing to explore the options with their partner and physician. Some options for vaginal dryness are the same whether a patient has had breast cancer or not. Many patients are able to use small amounts of topical hormonal therapies that can improve symptoms. Other women choose not to use hormonal therapies and instead invest in a good lubricant and topical moisturizers. A careful exam will help a woman and her physician decide which treatment option is most likely to improve symptoms.
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So what do you do after you survive cancer if life in the bedroom is not everything you want it to be? I encourage patients to take a step back and evaluate their situation. Are you disappointed with your degree of sexual desire? Are you unhappy with the way your body looks or feel like you are no longer “yourself”? Have you tried to restore intimacy only to discover you now have pain with intercourse? Is the lack of breast/nipple sensation part of the problem?
Once you can identify the things you are frustrated by, it is time to see your doctor. He or she should listen to your concerns and help you develop strategies for treatment. This might include medications, physical therapy, recommendations about devices that can help you or even sending you to a licensed sex therapist.
Life after cancer will never be the same as life before cancer. It can be better though – equipped with a new sense of purpose and direction in life. I have seen many women do amazing things as survivors. Don’t settle for less than the best life you can have – address your concerns and seek out solutions to intimate problems after cancer treatment.
Melissa Hague, M.D., is an obstetrician and gynecologist with Heartland Women’s Group and the Women’s Sexual Wellness Clinic.