Going through breast cancer is a life-changing experience, and returning to your everyday routine after getting the ‘all-clear’ can be challenging. Even just feeling like yourself might be harder than anticipated as it often comes with a lot of emotional and physical complications.

For some women, getting their sex life back after cancer can be particularly tough. Changes to your body might make you feel self-conscious. The physical symptoms of treatment could make it hard to feel pleasure or to revive feelings of sexual desire. Findings revealed that 350,000 people in the UK have sexual difficulties as a consequence of breast cancer and its treatment.

Once you’ve waited for the recommended amount of time given by a member of your health care team, and you feel ready to have sex again, you must address any signs of female sexual dysfunction as early as possible. If it goes ignored it can cause relationship conflict and also affect your mental health.

Dr Rekha Tailor, founder and medical director of Health & Aesthetics, said: “Although it might be more challenging to have sex, there are a number of ways that can help ease pain during intercourse, improve confidence or improve your sex drive. It just takes time. But it’s very important not to give up on this huge part of life.”

Pain during intercourse

Some breast cancer survivors may experience pain during intercourse, due to vaginal dryness. This can be a symptom of premature menopause, which can be triggered (temporarily or permanently) by certain forms of cancer treatment such as chemotherapy.

Menopause dilutes oestrogen, the primary female sex hormone. It can also cause stress urinary incontinence, a loss of libido and difficulty reaching orgasm. This can result in vaginal atrophy which is a thinning, drying and inflammation of the vaginal tissue.

Applying a water-based lubricant during intercourse to you and your sexual partner can instantly but temporarily relieve any pain or discomfort caused by mild dryness. Vaginal moisturisers can be applied more regularly (two to three times a week) to improve dryness.

There are hormone replacement therapy (HRT) options available in a cream, tablet or ring form, that can sometimes be used to help improve dryness. However, this may not be suitable if you have a history of breast cancer.

If the dryness persists and you want a long-term solution with no side effects, you could undergo a vaginal rejuvenation procedure such as Femilift. Three monthly sessions that take just 15 minutes each are required to achieve results lasting between 12 and 18 months.

Dr Tailor added: “This pain-free treatment can ease menopausal symptoms such as painful sex, urinary incontinence and vaginal atrophy. It helps to rebuild and tighten the vaginal tissue with a laser that stimulates collagen growth. The procedure also increases sensitivity, tightness and lubrication.

“However, this option is only suitable for women that have been given the ‘all-clear’ from breast cancer and aren’t still undergoing any treatment.”

Pain during intercourse can also be triggered or worsened by stress, anxiety and fear. This can cause vaginismus, which is when the vagina braces very tightly and doesn’t let anything in. Inserting silicone vaginal dilators with lubricant a few times a week can help relax the muscles around the vaginal entrance and minimise pain during intercourse. Practising mindfulness can also help minimise any negative feelings towards sex.

Lynn Buckley, a clinical nurse specialist said: “Focus on what’s actually happening to your body in that moment as opposed to what might happen in 10 or 20 minutes.

“If you aren’t multi-tasking and you’re fully aware of the intimacy and connection in that moment, it can prevent that fear and anxiety of ‘what if it hurts?’”

Loss of libido

The physical symptoms of breast cancer and treatment (such as nausea and fatigue caused by chemotherapy) can often result in a reduced sex drive.

Dr Tailor added: “Any physical causes to a loss of libido will need to be addressed by a medical professional as each person’s situation is different. If the root of the problem is your current medication, discuss with your doctor whether there are any similar options without the side effects.”

A loss of sexual desire can often strive from psychological issues. Around 240,000 of people in the UK are reportedly living with mental health problems after being treated for cancer. This can vary from moderate to severe anxiety, depression or post-traumatic stress disorder (PTSD).

If you’re considering taking anti-depressants, you should be aware that this medication can also result in a loss of libido and make it difficult to reach orgasm. Make sure you discuss the benefits and side-effects thoroughly with a member of your health care team. Addressing depression through counselling might be more suitable.

A reduced sex drive can often be caused by worries and anxiety. You may be worried that intercourse will hurt. You also might just not feel sexual after going through a difficult time. Some women struggle to concentrate during intercourse without being interrupted by negative thoughts surrounding cancer.

Lynn added: “Hopefully over time, you’ll begin to feel more positive about life. The fear of cancer coming back can hang over anybody but it’s about making sex about sex.”

“I think the biggest thing is to get as much help as you can and just because the health professional doesn’t bring it up, doesn’t mean that you can’t.”

Although getting the ‘all clear’ is a huge relief, dealing with the aftermath of having breast cancer can conjure complicated feelings. The effects on your body, mind and relationships can be difficult to overcome but you may just need to find your ‘new normal’ to achieve a satisfying sex life.

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