SEXUALITY AND INTIMACY AFTER BREAST CANCER (A FRANK DISCUSSION ABOUT A SENSITIVE TOPIC)
This booklet is provided as a service by AstraZeneca Pharmaceuticals LP. It is not a substitute for a full discussion with your doctor about your condition and its treatment. The list of resources on page 19 is provided merely as a convenience. AstraZeneca takes no responsibility for the content of, or services provided by, these resources and makes no representation as to the accuracy or completeness of any information provided. AstraZeneca shall have no liability for any damages or injuries of any kind arising from the information provided. Please see accompanying full Prescribing Information. IN YOUR CORNER is a trademark of the AstraZeneca group of companies. ©2007 AstraZeneca Pharmaceuticals LP. All rights reserved. 6/07 249662 let’s talk about it
One study presented at the When you were first diagnosed with breast cancer, it’s doubtful American Society of Clinical that your sex life was a top priority. Trying to figure out your Oncology Annual Meeting treatment options and coping with this sudden and dramatic found that while women’s change to your life likely took center stage. sexual function declined over 6 months of postsurgical Now that you’re further along in your treatment, issues of treatment, it rebounded intimacy and sex may be of more importance to you. And that’s 6 months later.1 natural. But the experience of having breast cancer and how it affects you – both physically and emotionally – can affect your sex life in many ways. We’ll explore some of the more common physical and emotional issues, and offer some ideas on what you can do to resume – and maintain – a healthy sexual life.
1Mortimer JE, Burke B, Fisher S, et al. Changes in sexual function over time in women receiving adjuvant therapy for early stage breast cancer. Presented at: 2004 ASCO Annual Meeting; June 5 2004; New Orleans, LA. Abs 622.
2 3 IT’S DIFFERENT FOR EVERY WOMAN
Some good news: Research has shown that after the first 6 months of adjuvant treatment, the majority of women with breast cancer have been able to resume satisfying sexual lives.2 Of course, every woman’s experience is different. What kind of surgery you had, whether you had or are having reconstructive surgery, chemotherapy, or radiation administration, and whether or not you are taking hormonal medications – these are all factors that may affect your body image and how you feel physically.
However, many researchers and health care professionals agree that women who had a positive body image and satisfying sex life before their breast cancer diagnosis are more likely to resume enjoyment of their sex lives after their diagnosis.
2Mortimer JE, Burke B, Fisher S, et al. Changes in sexual function over time in women receiving adjuvant therapy for early stage breast cancer. Presented at: 2004 ASCO Annual Meeting; June 5 2004; New Orleans, LA. Abs 622.
5 4 WHAT’S HAPPENING PHYSICALLY?
Common sexual side effects3 Being diagnosed with breast cancer and going through the •Difficulty reaching climax various stages of treatment can take its toll on your overall •Loss of desire for sex energy levels. When it comes to sex, it may take you longer •Pain during sex to become interested, if you feel any interest at all. •Reduced size of the vagina •Vaginal dryness Some breast cancer treatments can cause sexual side effects. First of all, there’s the pain and discomfort of surgery. Chemotherapy may lead to nausea and deplete your energy. It can even cause vaginal ulcers, which can make intercourse painful. Chemotherapy, along with hormonal treatments, can hasten menopause and the symptoms that go with it. Loss of libido (sex drive), vaginal discomfort and dryness, and hot flashes are all possibilities.
3Mayo Clinic. Sexuality after cancer treatment: What women can expect. http://www.mayoclinic.com/health/cancer-treatment/SA00071. Accessed March 12, 2007.
6 7 WHAT CAN HELP?
Fortunately, there are treatments that may help with sexual side effects. For vaginal dryness or discomfort, try using a water-based lubricant or moisturizer designated for vaginal use. These can be bought over the counter at your local pharmacy. You may also want to ask your doctor about low-dose hormonal creams, which can help restore the lining of the vagina. Your doctor can help you decide if these creams are appropriate if you’re on hormonal treatment.
Your doctor, nurse, or other health care professionals may suggest other ways that may help manage or lessen side effects such as hot flashes and lowered libido. While sex can be an uncomfortable or sensitive topic, you have the right to seek information from health care professionals and know your options.
8 9 WHAT’S HAPPENING EMOTIONALLY?
The anxiety, depression, and stress that often come with a breast cancer diagnosis may decrease, or flat-out eliminate, your interest in sex. Not to mention the body image issues, such as scarring, that can come with surgery.
Studies show that what partners mostly care about is that their loved one is alive and feeling well. In comparison, physical changes are of less importance. Even if your relationship is very strong, you and your partner will have to cope with the effects of your diagnosis and treatments.
10 11 TALK IT OUT
Getting back into the groove Even though sex is a familiar topic, when it comes to issues Be romantic. of sex and intimacy, communication is crucial. Talk openly Plan a relaxing candlelight dinner. Take a bubble with your partner about how you’re feeling. If you’re not in the bath. Take the time to nurture yourself. mood for intercourse for a while, your partner will probably understand. There are other forms of intimacy, such as kissing, Do something different. hugging, or giving each other a back or foot massage, that may Change your sexual routine. Experiment. Buy a help you keep close. pretty nightie. Try new things. Have fun. Talk about your biggest fears. Women may be afraid their Get some advice. If you’re having trouble discussing sex openly, partner will leave or reject them. Your partner may be afraid consider seeking advice from a therapist/marriage of physically hurting you during sex. Discussing your thoughts counselor, or joining a support group. You can and feelings can help you reassure each other that you are both go with your partner or by yourself. aware and sensitive to the other’s concerns.
Make it easier. Once you are ready to go further, try new things. Breast Sex may be painful if you do not have as much cancer may change what you like to do and how you like to be natural lubrication as you once did. Over-the- touched. You may find that your partner is willing to do what counter lubricants that may help alleviate dryness, discomfort, or pain are available at your local will make you happy – and vice versa. pharmacy. Feel free to ask your doctor or nurse about other ways to counteract sexual side effects.
12 13 IF YOU’RE SINGLE
Women who are not in a relationship at the time of their diagnosis and treatment have a different kind of challenge. They may worry about how having breast cancer might affect their prospects of meeting someone – and about how and when to broach the topic when starting a new relationship. Remember this – you don’t have to bring it up until you’re comfortable and ready to do so.
Breast cancer has become so common that many people have someone close in their life who has dealt with the disease. There’s no way to predict how any individual person will respond, but there is no doubt that many people are supportive and prepared to continue the relationship.
14 15 REMEMBER, YOU’RE NOT ALONE
Studies show that what partners Issues surrounding sexuality and intimacy are faced by virtually of breast cancer patients care every woman who has had breast cancer at some point. How about most is that their loved each woman approaches them is different. In this pamphlet, one is alive and feeling well.4 we’ve listed several books and Web sites that provide more information. We also encourage you to have discussions with a health care professional with whom you feel comfortable. You might also consider a support group or a counselor who specializes in these issues.
We hope you find this information and the suggested resources valuable and relevant. Enjoying and expressing your sexuality is a healthy and normal part of life. And as someone who’s been through a tough time, you deserve all the enjoyment that life can offer.
4Breastcancer.org. You and Your Partner. http://www.breastcancer.org/intimacy_partner.html. Accessed March 12, 2007.
16 17 Here are some books and Web sites that can provide further WANT TO information and support:
Living Beyond Breast Cancer: A Survivor’s Guide for When LEARN MORE? Treatment Ends and the Rest of Your Life Begins, by Marisa C. Weiss and Ellen Weiss. 1998 (Times Books).
Sexuality & Cancer for the Woman Who Has Cancer and Her Partner, by the American Cancer Society. 2001.
What’s Happening to the Woman I Love? by the Susan G. Komen Breast Cancer Foundation. 2005.
Your Breast Cancer Treatment Handbook, 6th ed., by Judy Kneece. 2004 (Educare, Inc.).
Sexuality and Fertility After Cancer, by Leslie Schover. 1997 (John Wiley & Sons).
Breastcancer.org On the Home Page, click on “Sex and Intimacy.”
Komen.org On the Home Page, search under “Sexuality and Intimacy.”
Y-me.org On the Home Page, go to “Coping and Quality of Life” and click on “Intimacy.”
Cancer.org On the Home Page, search for the article “Sexual Impact Following Breast Cancer Treatment.”
18 19