Welcome to the new monthly Sex Matters column on Breastcancer.org. I am honored and overjoyed that Breastcancer.org has the vision to include this important topic for their followers and for all women who are living with breast cancer.
As a sexual medicine gynecologist and a certified sexual therapist, I hope to bring to light some of the complexities of breast cancer sexuality.
Each month in Sex Matters, my focus will be threefold:
- We’ll discuss the treatment-related physical issues that affect sexuality, including changes in the body, hormones, and brain chemicals.
- We’ll also talk about the psychological issues that can impact sexual function, including mood changes, dealing with stress, depression, and sexual self-esteem concerns, or how a woman views herself as a sexual being.
- And finally, we’ll provide some practical suggestions to help women reclaim their sexual selves during and after treatment.
Who should read Sex Matters? Any woman, regardless of type of diagnosis or time with breast cancer, can benefit. We also encourage partners, if available, to read the column each month! And Sex Matters isn’t just for the young survivor — sexuality is a vital part of the adult human experience, no matter what your age! You’re never too old.
According to most statistics, approximately 50-90% of women who’ve been treated for breast cancer suffer from one form of sexual problem either during or after cancer treatment. Approximately one-fourth also report long-lasting sexual problems up to 20 years after their cancer diagnosis and treatment, and most feel that their sexual issues developed because of the medical and psychological changes that occurred at the time of treatment. Although sexual issues are common after breast cancer treatment, it’s crucial to remember that there are safe, effective interventions that can help revive and restore sexual health.
Sex Matters will address the most common sexual problems including issues with desire, arousal, lubrication, and sexual pain. The column will also discuss the changes that many women experience, including changes in orgasmic strength and intensity during breast cancer care. We hope to provide practical suggestions for you. Expect some take-home exercises, suggestions, and links for resources. We also encourage you to use the comments area below to submit your questions about sexuality during and after treatment, or email us at sexmatters@breastcancer.org. We’ll select some of them to answer in future columns!
Sex matters for women diagnosed with breast cancer. Sexual health and wellness is overall health and wellness.
I’ll see you here next month, when we’ll talk about vaginal dryness, answer some of your questions, and offer practical suggestions.
We hope you enjoy the column!
Michael
Lamp says:
Hi , I Would be very interested in a natural alternative for vaginal atrothy, painful intercourse etc. I have tried replens, with no success. Using vaginal dialators, no success . And am now trying Mae by damiva, Was diagnosed in Oct. 2012, had bilateral mastectomy Nov. I’m on Arimidex. I’m a very healthy 55year old , married 34 years and am wanting my old life back ! Look forward to hearing for you! Thank you!
tangandchris says:
Hello Doctor Krychman,
My sex drive is gone and when we try to have sex I feel nothing. It’s awful and NOT how things were prior to my cancer. I haven’t talked to any of my doctors about this, I’m not even sure where to begin. I’m 40 years old and not ready for my sex life to end, and neither is my husband. Is this something that will resolve itself further out from treatment? I’m also concerned because I will start hormone therapy as well and I’ve heard this can further damage sexuality.
Thank you for your time.
Michael Krychman, M.D. says:
Hello, and thank you for your questions! I know it’s not always easy to mention these concerns to your doctor.
There are lots of options for addressing vaginal atrophy, and there are absolutely things you can do to get your sex drive back.
I’ll be talking more in-depth on these subjects in future columns!
–Michael
SoLinda says:
I have been taking an aromatase inhibitor for the past 3 years and am seriously thinking about quitting because of sooo many horrible side effects which I am experiencing … When I do stop taking an AI, will in fact, some of the side effects go away (such as vaginal atrophy, painful sex, etc.?) I now take Warfarin because of a pulmonary embolism experienced during chemo, and the chance that I may have a blood clot whilst taking an AI – this makes taking any other medications very difficult …
Tammy_M43 says:
Hi, I’d also like to explore the vaginal atrophy issue. Like Lamp I’m 54 almost 55 and I’ve tried a couple of options without success. Thanks for raising the important issue of sex!
onehappyone says:
Yes I am also in the same boat. I would like my life back, but know that this is not possible. I had my ovaries removed and now I have no interest in sex whatsoever. Also it is so painful that it feels like there is no opening at all. It really hurts and want to know how I can get back my sex life.
Any help would be much appreciated.
kathec says:
thank you Dr. Krychman, for addressing this issue that affects so many women after treatments! If only just that one aspect of my pre-bc life was restored a little, it would make me- and my man, tremendously happy, and just make me feel alittle more normal. Thanks for showing up here in such an intriguing way, and I for one, am looking forward to your column, and i am now going to look at the link you included.
Keryl says:
In your column, I’d like to know your opinion on Estring. I know what the pamphlet says on warning….but I have had two oncologists and a gynecologist say that they recommend it for increasing flex and moisture and that it’s localized, not systemic. I don’t know what to think or if I should try it. I was estrogen positive. Any alternatives that are safe (safest)? I am 55, diagnosed 5 years ago, and ditto the others. On Femara.
kathec says:
i am on femara, and my onc finally gave me a script for e-strace, but i am mentally so far away from resuming my wonderful pre-bc sex life, and my man finds it hard to look at me as anything but “medically”, he is not a bad man at all, just, what used to be great, is now altogether gone.
ICanDoThis says:
And let’s not forget the postings in I want My Mojo Back
https://community.breastcancer.org/forum/7/topic/69566?page=108#post_4043879
honeybair says:
I am so pleased that our sexuality will not be forgotten because it is such a vital part of our lives and for many of us our marriages. We welcome your advice, Dr. Krychman, and are anticipating that you can help mend our broken sex lives.
Michael Krychman, M.D. says:
Hello, everyone! I’m glad you’re bringing these important concerns to the table. Vaginal atrophy is a serious issue happening for many women who’ve gone through breast cancer treatment and/or menopause. There are many treatment options for atrophy, and I will be addressing these in a future column. I’ll also be discussing the effects of breast cancer treatments, including hormone therapies such as AIs, on sexuality and what you can do about them, the risks associated with localized estrogen, and some of the psychological challenges of getting back into the sex life you once had.
In the meantime, you can listen to my first Breastcancer.org podcast, where I talk about some of these issues.
There will be more columns and podcasts to come, and I will be addressing the questions you post here and at sexmatters@breastcancer.org! The next Sex Matters column in early August will focus on vaginal dryness, so I welcome any questions you have on this topic.
Best,
Michael
jwood1176 says:
i am very interested in these blogs. I have been having issues for years and i am only 37 years old.
coni says:
Hello, Im so thankful for having you and addressing this issue, I was diagnose at 31, was married. After cancer I felt my husband was no longer interested in me and so we got separated,I met someone (long distance) else, at first everything was great, I slowly started to get depressed, I don’t know if it’s the medications, or just me being insecure, I’m brca 2 so had double mastectomy, ovaries were taken out for precaution, (which I regret, having agreed) my ex husband couldn’t have kids so, I didn’t think we would go our separate ways. And so now, with the new relationship, I feel like I can’t possibly be enough for anyone. Sex, with my new partner was not as painful in the beginning as it is now, I’ve too tried replens, onc adviced the ring but my family doctor wasn’t too crazy and asked me to maybe wait out. I had reconstruction, but no matter what I see, is not the same. Never will be, my hair came back thinner, I use to be so proud of hair to me was my best feature, all I get is be thankful. I am, to be alive, but between no sex life, and depression is hard to be. I’ve tried depression meds, but whatever little libido I have that kills it.
I don’t know what else to do. I feel I have so many issues, i know my boyfriend wants kids and I can’t give them, I’m always thinking he will leave me, I’m always comparing myself to other women. I’m reLly tired. I’m seeing a psychiatrist once a month, helps a bit but I just don’t know what to do. I’ve tried working, and it just too hard. Between hotflashes, depression and anxiety.
Pls help me!!
ncollett says:
I have the same issues and I am glad to hear that I am not the only one and that there is nothing wrong with me that there is a reason for it. I want to have my life back as well and make my husband of 28 years feel like I love and care about him as well. I am trying to educate him as well so he is informed and knows that there is a valid reason as to why I am not interested in sex and that it has nothing at all to do with him.
Kimberly1965 says:
I had a total hysterectomy several years before my BMX and cancer treatments. I have no desire for sex. I don’t feel like a human. Definitely don’t feel like a woman. Vaginal dryness has been an issue for years. I am a 1 1/2 year post BMX and year past chemo. I finished herceptin in mar of 2014. What can I do to get my sex drive back?