How breast cancer affects you sexually will be unique to you. Any changes to your body may affect your confidence and feelings about yourself as a woman. You might be anxious about your first sexual experience following your diagnosis, or worried things will not be the same as before.
All of these worries are normal and it may take time for your confidence to return and for you to feel comfortable being intimate with a partner or having sex again.
1. How your partner may react
If you have a partner, they will also face a time of readjustment after your diagnosis and treatment.
How your partner responds to you sexually may be influenced to a degree by how they reacted to your breast cancer. While some people’s sex lives will continue much as before, some partners may take on an overly protective role, which means they try to do everything for you and protect you from any further distress. They may not want to mention or initiate sex for fear of upsetting or hurting you.
Some partners need time to accept what’s happened. Others cannot come to terms with their partner’s breast cancer and may emotionally push them away or even reject them, temporarily or permanently.
Try talking to your partner about how you feel. This might encourage them to share their own thoughts and concerns. You may find you’re making assumptions about how the other feels without realising it.
Your partner may also find it helpful to read our booklet When your partner has breast cancer.
2. Talking to your partner
Each person’s intimate and sexual relationships will be unique. Things may be different after a breast cancer diagnosis and you may need to adapt to your new situation.
However, if you and your partner can communicate supportively with one another, there’s no reason why your sexual relationship shouldn’t be satisfying and fulfilling for you both.
Tips for talking to your partner
- While it may be difficult at first, try to be open and honest about how you are feeling – this can avoid mixed signals, and make your partner aware of your limits
- Talk to your partner when you’re not being intimate, so you don’t feel awkward or interrupted during those times
- If there are aspects of intimacy that you feel uncomfortable discussing in person, try emailing or texting instead
- Talk about the things you’ve been enjoying as well as those you’ve found difficult – this can help you both to feel encouraged and relaxed
- Keep talking to each other to make sure you are clear about any boundaries and have the same expectations
Finding new ways of continuing to be intimate with your partner may help you to adjust to the physical and emotional changes that have happened until you reach a point where you feel more comfortable.
Often ‘full sex’ is seen as meaning penetrative sex, but try thinking more widely about sex and consider other ways to be intimate. You might find this reduces your anxiety and allows you to enjoy your body and/or a partner’s body in a different way.
It’s worth bearing in mind that many women adapt to changes to their body over time and continue to have fulfilling relationships and lives after breast cancer.
3. Changes to your relationship
If you’re in a relationship you may find that it changes. For example, couples facing cancer can feel emotional distress, and when both partners are under stress the relationship can become strained.
Any changes to your relationship may be positive or negative, and some things will be easier to deal with than others. Changes may be difficult to talk about with your partner and it may take some time to resolve them.
The quality of a relationship, both generally and sexually, before breast cancer, is likely to have a large bearing on how a couple copes with the experience of a diagnosis and treatment. Breast cancer may not always cause problems but it can often aggravate existing ones.
If you had problems in your relationship before having breast cancer these will not necessarily have gone away. Your illness will almost certainly make you re-evaluate many things in your life, including your relationship. Some people may decide that they no longer want to stay in a relationship where they are unhappy. Others may feel they need the security of their relationship even if it isn’t an entirely happy one.
Being able to talk openly about your situation can mean that together you are able to find solutions. This may be a gradual process but avoiding problems altogether may make them more difficult to resolve in the long run.
Some women find the experience brings them and their partner closer. Together they have the strength to carry on and overcome whatever difficulties breast cancer brings. This is not always the case, though, and even strong and close relationships can be tested by, and sometimes end after, a diagnosis of breast cancer.
Dealing with something like cancer will change a relationship during the course of the illness and may be particularly difficult if the relationship is new. If you’re in the early stages of a relationship you may find that you’re discussing important issues much sooner than you would have liked.
4. Starting a new relationship after breast cancer
Sex after breast cancer
If you’re not in a relationship, you may find the thought of forming a new one daunting. You may no longer have the same confidence in yourself and how you appear to others.
Beginning a sexual relationship may also bring on feelings of anxiety – for example, about telling someone you’ve had surgery for breast cancer and at what stage you should do this.
If you weren’t in a relationship when you were diagnosed, or your relationship ended after your diagnosis, meeting someone new may mean telling them about your breast cancer. Deciding when and how to do this can be difficult.
You may feel there isn’t a right time to talk about this or be unable to find the words. But as you get to know someone and feel more comfortable with them, you may find it easier to talk about all aspects of your life, including your breast cancer.
When you feel the time is right to tell your new partner they may respond in a number of ways. They may initially be shocked and take a little time to adjust to this news. They may have their own anxieties and fears around cancer and what it means to them. Or your new partner may be very accepting of your history and recognise that your experience of breast cancer is now part of who you are.
When you start a new relationship, you and your partner will decide on the right time to be intimate. If you’re feeling anxious about this because of your breast cancer, talk to them about your concerns and the specific things you are worried about.
5. Help if you need it
If you’re concerned about any issues relating to how you feel about your body or sex life that you want help in resolving, it may help to talk to your treatment team, breast care nurse or GP in the first instance.
Even if it’s been a while since you finished your treatment, your breast care nurse will still be a useful point of contact. They may be able to help with any questions you might have – for example, if you want to know more about breast reconstruction, how to cope with vaginal dryness or if you’re concerned about menopausal symptoms.
You can also call our helpline to talk through your feelings and concerns with one of our nurses.
Sometimes you may need specialist help. This may mean you, or you and your partner, seeing a counsellor or a therapist who deals specifically with sexual issues. Your GP or breast care nurse should be able to help arrange this for you. Alternatively you can contact an organisation such as COSRT (College of Sexual and Relationship Therapists), RELATE or IPM (Institute of Psychosexual Medicine).
Most people with breast cancer who experience sexual problems don’t need long-term therapy, but you may find it useful to talk to someone about a particular problem or at a particular point in your treatment or recovery.
Talking about changes to your body, sex and intimacy can be difficult. But addressing your concerns is an important part of your breast cancer treatment and care. Our prompt list (PDF) is designed to help you discuss these issues with your healthcare professional or when calling our helpline, below.