Talking with your partner about sex

Breast cancer can have physical and emotional impacts on your sexual life. Surgeries change the way your breast and body looks and feels, and medical treatments can cause menopausal side effects like lowered libido, vaginal and vulvar dryness, fatigue, hot flashes, and joint pain. Many women report struggling with these changes and the impacts on their sexual relationship with their partner. When it comes to talking about sex and intimacy, breast cancer can test even the strongest relationships.

Communication is key to keeping relationships strong, but it’s not always easy to start a conversation about sex. Here our community offers some tips to get the dialogue started.

Start from a position of knowing you both have concerns

Women report a variety of concerns with their sexual lives. Mastectomy or lumpectomy may have left you without breasts or nipples. The swelling of lymphedema changes the way women feel about their bodies, dressed or undressed, and can impact function. And areas that when touched in the past gave pleasure — the vagina and vulva, the breasts, other erogenous zones unique to you — may now feel numb, dry, painful, or just plain different. Some women question whether their partners will still feel attracted to them, even as they begin to learn the landscape of their changed bodies.

Partners report different feelings: worries about how to show support and affection, concerns about hurting you or causing you pain. Many partners look for direction about when to resume a sexual relationship.

Sex and intimacy after breast cancer: Communicating your needs

Sage Bolte, PhD, LCSW, CST discusses communicating sexual needs with your partner while managing a long-term health condition. Watch the full video here.

Talking openly and honestly can help

Here are some tips to kick off a conversation about sex or intimacy.

Just start talking

Discuss friends or common interests to make it easier to bring the conversation around to your fears or your concerns about your romantic relationship.

• Choose a quiet time to talk, with less chance of interruptions.
• Even if your partner isn’t a talker, that doesn’t mean they aren’t listening. Make eye contact and touch your partner as you speak, to give your words greater meaning.

Reassure your partner

Make it clear you want to know their concerns. This sends the message you are in the situation together.

If your partner is quiet, don’t assume they don’t care. Your partner may not want to burden you with their fears about your health, or simply may not know what to say.

Write down your concerns

Sometimes writing a letter and giving it to your partner is easier than saying the words face to face.

If you decide to write a letter, find a quiet time to talk about what you wrote once your partner has had a chance to read it.

Be clear with each other

Let your partner know where you do, and don’t, want to be touched. If your partner worries about hurting you, agree on a signal you will use if you feel pain. It’s also important to let your partner know when something feels good.

Use touch

Physical closeness, giving and receiving a hug or kiss, or holding hands can help you stay connected.

Seek guidance

Ask your cancer center social worker to recommend a couples counselor or sex therapist. You can talk with a couples counselor or sex therapist alone or with your partner.

For some people, it can also be helpful to talk with other people who have been diagnosed with breast cancer. Visit Where to find breast cancer support to learn more.