Body image and intimacy

Hi Kerry,

Well done for being brave and bringing up the sensitive subject of intimacy post BC treatment. I also had HR+/ HER- BC and had a single mastectomy, plus ANC (4/9) but no reconstruction (I wasn't offered one). I also had chemo, radiotherapy and am on abemaciclib and zoledronic acid infusions. I quite like my body post surgery because my mastectomy scar is neat and has faded to a fine line, but I have lymphoedema in my left arm which I'm sensitive about because I have to wear a horrible flesh-coloured sleeve every day which doesn't make me feel very sexy.

My husband and I managed to continue with intercourse until around cycle 6 of chemotherapy at which point it just became too painful. Initially I thought this was due to the particular type of chemotherapy because both of us experienced a burning sensation during sex which made it uncomfortable rather than pleasurable, but later on I realised it was due to menopausal vaginal atrophy brought on by the chemotherapy. 

We've tried to maintain an intimate relationship since then, essentially pleasuring each other manually or through oral sex. My GP prescribed me a vaginal moisturiser (non-oestrogen based) which I was supposed to apply 2-3x per week, but the consistency was difficult to get inside me (it was very runny) and I gave up. I probably should have gone back and asked for something else so it's definitely worth investigating.

More recently, we've used occasions when I am feeling particularly well lubricated to try penetrative sex again. So far, the penetration achieved is about 1 inch before we essentially hit a brick wall as my vagina is very tight with no muscle for any "give". However, the sensation is still slightly pleasurable (more like a memory of sex than anything that will result in an orgasm) and we both feel that with a lot of time, patience & lubrication, we might just achieve more penetration so that's the journey we're on. 

Interestingly, I have made friends with a few women who also had BC, many of whom are younger than me and had less challenging treatment (e.g. no chemo), yet none of them seem to be having much intimacy in their relationships. I'm not sure why. Is it because of body image issues? I guess I am lucky to have a husband who is willing to try things, be patient and go at my pace.

I hope you find a way to bring back some much needed confidence in your body and to be open with your husband about what you think you can accommodate (now, and potentially in the future) and to take the lead. I'm sure he will be understanding and happy to be guided by you. 

All the best! xx

Thanks Anne, for your honest and candid reply.

i really do think the time has come for me to realise I can’t fix this alone and to seek help. I currently don’t see much hope in my sex life being revived without it.

Best of luck with yours xx

Hi

This is a difficult area to discuss and I am not sure if what I have to say will be helpful.  I am 3 years post BC diagnosis and the journey back to intimacy has been challenging.  My husband and I were able to have couple counselling through the Dimbleby Centre at Guy's.  It really helped us to turn a corner.  It was not specifically  about the sexual side of our relationship but it helped us in our communication with each other.

We are now able to reach full organism which is great.  I am not sure I feel particularly sexy but I have learnt to accept my body image as it is.  I had a double mastectomy with breast reconstruction using implants. 

A sexual relationship was important to us so we both wanted this.

All the very best in your journey

I used to be a Trustee for an organisation that provided counselling services, including sex therapy, and got to know some of the therapists quite well. I really think something like that could help both of you understand each others’ perspectives and find a way forward. And as someone who has vaginal atrophy I would say don’t delay getting help for that - it will only get worse and could lead to physical discomfort and problems with UTIs if untreated. Topical oestrogen shouldn’t be a no no, and internal moisturisers also help. 

Thank you for taking the time to respond to me.

i think my first step will be to approach talking therapies and see if this helps unlock some coping strategies.

i know this will be a life long journey for us all- best of luck to you and your husband too xx 

Thank you 

is the organisation you mention a national one? Would you be able to share the details?