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May 2014 Ask the Expert: Body Image

During the month of May, Living Beyond Breast Cancer expert, Barbara Musser, answered your questions about body image after breast cancer, how to cope with the physical changes of treatment and how to work toward renewed self-love.

Remember: We cannot provide diagnoses, medical consultations or specific treatment recommendations. This service is designed for educational and informational purposes only. The information is general in nature. For specific healthcare questions or concerns, consult your healthcare provider because treatment varies with individual circumstances. The content is not intended in any way to substitute for professional counseling or medical advice.

How do I regain libido when the therapy I'm on sucks estrogen out of the body? What will move me towards the old normal sex drive?

Where do I find help to conquer treatment-induced weight gain? That kills self-image!

How will or when will I ever get my sex drive back again? I’m 8 years past breast cancer.

I do not feel sexual, do not feel comfortable with how I look and do not feel like masturbating. I know that I probably need to have a sexual relationship with myself again first but I just do not know how to get my groove back.

The only thing I did not foresee after my double mastectomy is the extra fat and flesh that seems to have accumulated in pockets in the back, near the shoulder blades, and on my upper arms. My doctor says it's not a big deal but it is a daily reminder of the big 'C'. How I can manage and camouflage it?

My husband has not touched me since my double mastectomy with reconstruction. What do I do?

I’m divorced and haven’t dated because I’m so self-conscious about my body after my reconstruction failed. I cannot imagine showing my body to a man again. I would love your input and perspective.

Question: How do I regain libido when the therapy I'm on sucks estrogen out of the body? What will move me towards the old normal sex drive?

Ms. Musser: The changes to libido that result from chemo and hormonal therapies can be large, unanticipated and sudden. The “old normal” sex drive has changed and hoping to get back to that state may not be realistic. Libido is largely, but not entirely, driven by hormones. Thinking that your libido will return to its former state can be a set up for disappointment. That said, it is entirely possible to revive your sleeping libido. Here are a few ideas:

My first suggestion is to expand your definition of S ~ E ~ X to have it mean Sacred Energy Exchange, Sensual Energy Exchange or Spiritual Energy Exchange. By doing this you take the focus off your genitals and orgasm and expand the universe of possibilities for pleasure. Our entire body is an erogenous zone. What a treat to explore it in it’s entirely and discover what brings you pleasure.

I suggest that you take orgasm off the table for a while and discover what else is possible. Try a kissing date, or sensual massage, or read some erotic together. These kinds of activities all bring pleasure in other ways.

The good news is that there is a wonderful program called the  Vaginal Renewal Program™, created by my friends at A Woman’s Touch.

The bottom line is to use this current state as a doorway into exploring pleasure. We have been trained to focus on our genitals and orgasm and there is so much more available. Give yourself permission to play, explore and love more.

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Question: Where do I find help to conquer treatment-induced weight gain? That kills self-image! Is there nothing to rev-up metabolism when taking Arimidex?

Ms. Musser: I am not a medical expert so can’t speak directly to your question about Arimidex. However, as you probably know, living a healthy lifestyle is the best thing for anyone on the cancer journey. Eat a healthy diet, exercise or move regularly and have a spiritual practice to feed your soul.

It is also important to love and accept your body as it is now. This will help with the self-image. Doing some mirror work is a powerful practice to shift your relationship with yourself. I will describe this in detail on the May 20 webinar, so please join us or listen in later to the recording.

Most women I speak with didn’t have the greatest self-image before diagnosis and treatment. We live in a culture with a narrow definition of beauty, which is mostly unattainable. Your cancer experience can be a doorway into doing some inner work to heal what needs to heal emotionally, psychologically, physically and spiritually. It’s time to define beauty on your own terms, not the culturally-imposed terms.

Think for a moment of who you consider to be beautiful women. It is usually much more than their physical appearance. A woman who is confident, comfortable in her own skin and radiates her essence is gorgeous. What are the qualities in you that you can cultivate to feel beautiful? What do you value? Focus there and see what happens.

A practice to try is creating a Love Jar. Make a list of all the qualities your love about yourself. Just write them down without editing, let them flow. You can also include qualities you want to cultivate in your to things about you that you want to love more. Then write each on a separate piece of paper and fold it into thirds or quarters.

Decorate a jar with images that evoke feelings of love in you. Place the messages in the jar. Each day, pick a message from the jar and commit to focusing on and cultivating that quality for the day.

Doing this Love Jar practice for a month or so will shift how you feel about you. It’s fun, inspiring, easy and feels good. I invite you to experiment with this and see what happens in your experience of your self-image.

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Question: How will or when will I ever get my sex drive back again? I’m 8 years past breast cancer.

Ms. Musser: There’s no question that our sex drive can go dormant during treatment and it can be challenging to revive it. However, if you are alive and breathing, it can be done. Read more in our previous question above. (Anchor)

My suggestion is to make a list of activities that bring you pleasure in any way and begin to focus on these. Do one each day and as you begin to experience more pleasure you’ll have more fun.

It’s also helpful to make a list of intimate and sensual activities that feel good to you: things like kissing, holding hands, touch, erotica, fantasy, aural sex (talking sexy), massage and so on. Brainstorm a list and do one each week. Make a weekly date with yourself or your partner if you have one, and do something from your list. Spend a few hours on pleasure without going directly after penetrative sex.

There’s a whole universe of pleasure possibilities. When we get in the flow of feeling pleasure and stop worrying about what’s missing, we relax and then things can begin to flow differently sexually.

Try this experiment for a month or so and see what happens.

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Question: I have not had sex with my boyfriend since January during chemo -- intercourse gave me a bad UTI (urinary tract infection). Frankly, I just do not feel sexual, do not feel comfortable with how I look and do not feel like masturbating. The fantasies I used to use seem banal now. I just feel sad looking at my lop-sidedness. I exercise, do yoga, try to eat right. I know that I probably need to have a sexual relationship with myself again first but I just do not know how to get my groove back. What are your suggestions? I had a mastectomy on one side and have been through chemo and radiation. Now I’m on tamoxifen and take Effexor for hot flashes.

Ms. Musser: Thank you for your honesty and questions. The thought of leaping back into sexual activity can be daunting after experiences like yours. My suggestion is to take intercourse, masturbation and orgasm off the table for now, and to focus on other ways to reconnect with yourself and your boyfriend. Sometimes we put so much pressure on ourselves to get back in the groove of what sex was like before breast cancer treatment that we can feel hopeless.

Here’s a suggestion to create a launchpad for intimacy: set aside an evening for you and your boyfriend to connect. Set the stage by putting clean sheets and soft pillows on your bed. Light lots of candles, burn some incense if you like it, and put on some soft sensual background music.

If you have some sensual clothing, wear it. Leave all other electronic devices elsewhere. Invite each other into your love nest. Sit on the bed and hold hands and look into each other’s eyes. Agree that this evening is about connection, intimacy and pleasure and that there is no other agenda.

Then lie down facing each other, either holding hands or with one hand on each other’s heart. Look into each other’s eyes and take a few deep breaths until you feel the connection between your hearts, your eyes and your bodies. Relax and breathe and be gentle and tender with yourselves and each other. Notice if you want more touch and if so, talk about what might feel good and then do that. That’s it, just be together and connect. Slow and easy, loving and tender.

My bet is that if you do this on a regular basis (weekly would be great), you’ll find that other feelings and desires will gently and gradually emerge.

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Question: Two years ago I chose to have a double mastectomy without reconstruction and am still comfortable with that choice. The only thing I did not foresee is the extra fat and flesh that seems to have accumulated in pockets in the back, near the shoulder blades, and on my upper arms.

I shy away from anything with short sleeves and am always conscious of how my back appears in a dress. My doctor says it's not a big deal but for me it is a daily reminder of the big 'C'. How I can manage and camouflage it? 

Ms. Musser: Ah, the “wings” that emerge after mastectomy. They make your body look and feel very different, don’t they? No matter what your doctor says, if they’re a big deal for you, they’re a big deal. You can investigate a little more surgery to remove them if you want.

If that’s not an option for you, find some clothing that has flowing sleeves that literally look like butterfly wings when you move your arms.

My other suggestion is to do the Mirror Practice that I described in the “You Are So Beautiful” webinar I gave on May 20. This is a practice that is designed to shift your image and acceptance of yourself.

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Question: My husband has not touched me since my double mastectomy with reconstruction. What do I do?

Ms. Musser: I’d like to know a little more about this. Do you mean that your husband doesn’t hug or kiss you, or that he’s not interested in sexual intimacy, or something else? Without knowing this, my suggestion is for you and your husband to have some open and honest conversations about what’s going on for both of you.

There are so many elements to intimacy and communication is the key. A good place to begin a conversation with him might be something like, “Sweetheart, I miss your touch since my surgeries. I’d like to know more about that and hope you’ll share with me what you’re thinking and feeling about touching me.” Then listen to what he says. After he has spoken, ask if he’s willing to hear about your experiences. If he is, tell him how you feel, what you miss, what you want and what it feels like emotionally and physically to not have touch.

Often, being willing to gently open the door to an intimate conversation is what it takes to build bridges back into intimacy.

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Question: I had a double mastectomy and then my reconstruction failed. I am divorced and haven't dated since 2010 because I'm so self-conscious about my body. Although I know my body will never be the same, I cannot imagine showing my body to a man again. This upsets me so much. I would love your input and perspective. 

Ms. Musser: Thank you for your vulnerability and tenderness! Being single and contemplating dating and sexual intimacy with a radically changed body takes courage, patience, a sense of humor and some grace.

When you say that your reconstruction failed, I’d like to know more about that. I know many plastic surgeons who work with women who need additional surgeries to repair or redo reconstruction. I don’t know if this is a possibility for you, but it’s worth researching.

The main suggestion I have for you is to do some inner work to accept, forgive and love your body as it is now. The key to opening to love with another is to love oneself first. There are several processes to help with this and I outlined them in the May 20 webinar. If you haven’t listened to it, please do. These practices and processes will help you with your emotional, psychological, spiritual and physical healing and rebalancing.

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Denver, CO  ·  September 13, 2014

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