As an educator, sexual medicine gynecologist, and counselor, I knew what I wanted to say, but words couldn’t translate into pen and paper. As I pondered the concept of breast cancer sexuality in the face of metastatic disease, it was apparent that this blog would be dedicated to women who were personally close to me — my grandmothers Rose, Tutu, and great aunt Oldie — and all of those courageous women who live strong each day with their diagnoses.  It’s also for the everyday women who have touched my life and helped me redefine sexual experience. Here’s what I’ve learned.

Even if your disease is at bay, you consider yourself cured, and you’re a survivor or thriver of cancer, the fear of recurrence is always in the back of your mind. A mere backache from overdoing yard work seems like a backbone met, a cough seems like a lung nodule, or a forgetful moment brings fear of brain lesions. Whether you have metastasis or are fearful of discovery, reclaiming sexual vitality is an essential aspect for living.

Here are some practical suggestions:

• Take pain medications: If you’re in pain, premedicate with pain medications so your level of pain is under control before sexual activity.
• Practice planned spontaneity.
• Look for comfortable positions.
• Plan the experience.
• Fatigue is a big buzz kill. Rest when you’re tired. Often sex in the morning is best. Men often have morning erections; fatigue and pain levels are often at their lowest level in the morning. And distractions like email, work, and social commitments are minimal.
• Redefine the sexual experience. Use your imagination. Sex is not only intercourse! Enjoy the journey and take your time.
• Communicate. Engage your partner. Speak openly about your concerns and fears, and share your thoughts about sex and sensuality. Feeling connected to your partner is often the first step in restoring sexual function after cancer.
• Take a chance on love and sex! A famous poet once said, “…if I take a chance sometimes good things happen, sometimes bad things happen. If I don’t take a chance, nothing will happen.” Risking reclaiming intimacy can result in a huge physical and emotional reward!
• Get help if you feel you need it. There are sexual medicine gynecologists who will collaborate with your oncological team to provide a comprehensive, safe, and effective treatment paradigm to address your sexual concerns.
• Believe. I know and believe that cancer is a chronic medical illness. Metastatic disease often can be controlled and managed. Sexual health is associated with general health and not only enhances emotional connectivity between you and your partner; it can release natural painkillers such as endorphins and help boost immunity.
• Hope and stay present. Take each day as it comes, be mindful and hopeful. Stay focused, sensual, emotional, and enjoy tenderness with your beloved.