• Breast cancer treatments, from surgery to chemotherapy, radiation and drugs like Tamoxifen, Raloxifene, and Aromatase inhibitors come with a host of both physical and emotional side effects.  Pepper Schwartz, Professor of Sociology, University of Washington and co-author of the New York Times best seller The Normal Bar: The Surprising Secrets of Happy Couples offers advice for the effects of poor body image, hair loss, mastectomy-related relationship issues and sexual dysfunction including loss of desire, painful sex, pain in breasts, and arousal issues.

    “Sexual problems are reported in up to ninety percent of breast cancer survivors. Even among those that experienced healthy sex lives prior to a diagnosis may find that they have become too self-conscious to enjoy intimacy again, especially after a mastectomy,” says Dr. Schwartz. “It’s best for couples to openly discuss their sexual and emotional issues together for greater mutual understanding and to implement adjustments for a ‘new normal’.”

    Here are tips on how to improve and navigate intimacy during and after breast cancer:

    • Reinvent ways to be intimate. If vaginal penetration is too painful, discuss what might be more comfortable, such as: hugging, kissing, oral pleasure, gentle massage, and mutual masturbation.
    • Vaginal dryness caused by diminished levels of estrogen can lead to severe symptoms ranging from irritation, to discomfort with intercourse, to cracking and bleeding of the vaginal tissues. Women with this condition suffer a great deal, especially cancer patients who are unable to use hormone therapy.  Regular use of non-hormonal, Replens vaginal moisturizer and a lubricant just before intercourse can help reduce abrasion and nourish vaginal tissue.
    • Fatigue is an issue many cancer patients face, so consider early morning or lunchtime sexual activity when you have more energy.
    • Self-esteem and changes in body image play a major role in intimacy for breast cancer survivors. Consider self-esteem exercises offered by the American Cancer Society such as wardrobe upgrades to feel sexy and lighting adjustments to mask scars if one feels self-conscious.
    • Control pain by taking over-the-counter pain medications prior to sex, as needed.
    • A breast cancer diagnosis and treatments can lead to depression, which can affect interest in sex altogether. Depression should not be ignored- discuss with your healthcare provider about appropriate treatment options.

    “Remember that honest communication with your partner is critical and intimacy or self-pleasure is important to your overall wellbeing and recovery. If you need a little extra guidance, chat with your health care provider to clear the air, dispel fears with fact and discover other solutions available,” adds Schwartz.

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    Article by: Dr. Pepper Schwartz

    Pepper Schwartz received her PhD from Yale University and is Professor of Sociology at the University of Washington in Seattle. She is the Past President of the Society for the Scientific Study of Sexuality, the National Sexuality Resource Center and the Pacific Sociological Association. Author of 17 books and over 50 scientific articles, she has been given several awards among them the American Sociological Association's award for Public Understanding of Sociology. She also serves as the AARP Love and Relationship Ambassador and is one of the founding members of Perfectmatch.com, for whom she created their matching system. She is the mother of Cooper and Ryder and lives on a horse ranch in Snoqualmie, Washington.

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