Feeling Sexy after Breast Cancer
Have you noticed in life how things seem to cluster and surround you at a moment when you are interested and noticing? The most commonly given example is, immediately after buying a new car, you see zillions of the same car on the road daily. There is a cliche among therapists that, whatever your current issues might be, patients with those same issues will come to your door. (Pretty obvious in my case since my two breast cancers have been quite important in my life and my professional work is mostly spent with women who have/had breast cancer.)
This is a preface for today's entry which is a light and nice article about feeling sexy after breast cancer; this came from the LA Times and the Orlando Sentinel. The related context is that I am preparing a talk about intimacy for a conference next week and yesterday it was the primary expressed concern of three different women with whom I spent an hour. The reassuring thing for them was to hear how normal their concerns are and that it does get better.
Here it is: http://www.latimes.com/health/os-sex-after-breast-cancer-20101026,0,3165334.story
Feeling sexy after breast cancer
By Marissa Cevallos, Orlando Sentinel
11:55 AM PDT, October 26, 2010
Clermont resident Gigi Burnside was 45 and just starting chemotherapy for breast cancer when she began having hot flashes.
"I kept wondering, 'Why am I sweating all the time?' " said Burnside. "Within two weeks, I was straight into menopause." She bought two portable fans.
The problem: Chemotherapy can push women into menopause, regardless of their age. But instead of slowly developing hot flashes and night sweats over one to three years, "chemopause" hits in a matter of two or three months.
"You get the side effects of women with natural menopause, but you get them immediately, like a truck hitting you," said breast cancer survivor and author Gina M. Maisano.
Those symptoms include vaginal dryness and painful intercourse. Coupled with bald heads and disfigured breasts, breast cancer survivors have a changed body image that carries over into the bedroom, according to a new study. In it, the majority of breast cancer survivors reported they struggle to be intimate again.
Researchers speculate that in breast cancer survivors, drugs used in their treatment block the estrogen needed to feel in the mood.
"There's no quick fix like Viagra," said Dr. Nikita Shah, an oncologist who oversees a breast cancer survivor's clinic at the M.D. Anderson Cancer Center in Orlando. "There are very few options for women."
About 200,000 American women are diagnosed with breast cancer every year. As treatments become more advanced, more women are surviving the disease. In the United States, there are 2.4 million breast cancer survivors, many of whom will be facing the side effects.
In the latest study, researchers polled nearly 1,600 Australian women under age 70 with breast cancer about their sex life. The vast majority remembered having a satisfying sex life before their diagnosis. Afterward, 70 percent said they had sexual function problems, and two-thirds of those wanted to increase their sexual desire. Nearly half said they feel different about their body image, even though only 12 percent said their partners were less happy about their appearance.
Patients who received drugs that block estrogen had more sexual problems. Women taking aromatase inhibitors such as Arimidex were 50 percent more likely to have sexual problems than those not on the drugs.
" Hormones have a big role to play in that," said Shah. "If you drop the estrogen level, yes it can affect the sexual drive." But it doesn't have to stay that way, says Maisano, who wrote a book on intimacy after breast cancer diagnosis.
"You can get your sex life back to the way it was, if not better," said Maisano.
The sex talk
Talking about sex to a cancer doctor can be awkward. "Usually it's not the patient who initiates the conversation because it's a private thing to be talking about," said Shah.
A gynecologist can point patients to practical fixes such as lubricants, said Maisano, because they've seen the problem before.
But if the new survivor doesn't feel comfortable in her body, it's hard to feel sexy.
"Their breasts never quite look normal again, or at least they don't look like the other side," said Shah. Women with sexual problems who had a breast removed were no more likely to have reconstructive surgery than women without sexual problems.
Even when women have reconstructive surgery, which most opt for, survivors say they feel unnatural at first, said Maisano.
"They look down at these new reconstructed breasts, and they say, 'This is not me. I don't feel like me,' " said Maisano.
She advises women to exercise to reacquaint themselves with the new body. Not only has working out been shown to improve emotional well-being, but it lowers the risk of developing another tumor.
At the end of the night, said Maisano, women who accept their new body find it easier to get in the mood. "We're so, so hard on ourselves, even if we don't have breast cancer," said Maisano. "It's the cellulite, the wrinkles. We have to lighten up on our self-image."
After all, their partners aren't always the harsh critics women imagine. After her mastectomy, Burnside spent a year with one breast before having reconstructive surgery at Leesburg Regional Medical Center.
"The man I'm with has made life so much easier," said Burnside. "One [breast], two [breasts], he doesn't care. I had to figure out how to be attractive to myself because I was already attractive to him."
Copyright © 2010, Orlando Sentinel