Sexuality after Breast Cancer
Posted 12/7/2011
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This is another favorite topic--and one that is not likely to grow old.Concerns or problems or issues about sexuality/intimacy during and after breast cancer treatment are very normal. I doubt that anyone goes through this experience without some pressure on her intimate life. One reality is that this is generally not much discussed, especially in the beginnibng, by our doctors. For sure, there is a great deal else that must be covered, and sex is not at the top of most women's worry lists when they first learn of a cancer diagnosis. There are exceptions: I can think of a few women who led with their questions and worries about sexuality.
So, what happens to most of us? We are distracted by other concerns (Am I going to die? Will I lose a breast? How sick will I be from chemotherapy? etc). We don't feel our most womanly and beautiful when recovering from surgery, bald from chemotherapy (and remember this applies to all body hair, giving many their first Brazilian), or burned from radiation. The drugs themselves mess up our metabolisms and sense of general well being, and being thrust into menopause brings those normal aging effects on sex. Translation: Most women are focused elsewhere than the bedroom, and most experience diminishment of libido and responsiveness. It does improve, a lot, as time passes, but many women feel that they never regain their pre-cancer passion.
This is an article from Breast Cancer Research about these issues. I give you the abstract and then a link:
Interventions for sexual problems following treatment for breast cancer: a systematic review
Sally Taylor • Clare Harley • Lucy Ziegler •
Julia Brown • Galina Velikova
Abstract
Sexual functioning is an important element of
quality of life. Many women experience sexual problems as
a result of a breast cancer diagnosis and its treatment. Little is known about the availability and the effectiveness of interventions for sexual problems in this patient population.
Six electronic databases were searched using Medical
Subject Headings and keywords. Additional hand searching
of the references of relevant papers was also conducted.
The searches were conducted between October 2010 and
January 2011. Papers were included if they evaluated
interventions for sexual problems caused as a result of
breast cancer or its treatment. Studies were only included if sexual functioning was reported using a patient-reported
outcome questionnaire. Studies were excluded if sexual
functioning was measured but improving sexual problems
was not one of the main aims of the intervention. 3514
papers were identified in the initial search. 21 papers were selected for inclusion. Studies were of mixed methodological quality; 15 randomised trials were identified, many included small sample sizes and the use of non-validatedquestionnaires.
Three main types of interventions were identified: Exercise (2), medical (2) and psycho-educational
(17). The psycho-educational interventions included
skills-based training such as problem-solving and communication skills, counselling, hypnosis, education and
specific sex-therapies. Interventions were delivered to
individual patients, patients and their partners (couplebased) and groups of patients. The widespread methodological variability hinders the development of a coherent picture about which interventions work for whom.
Tentative findings suggest the most effective interventions are couple-based psycho-educational interventions that include an element of sexual therapy. More methodologically strong research is needed before any intervention can be recommended for clinical practice. Improved screening and classification of sexual problems will ensure interventions can be more effectively targeted to suit individual patient needs.
Breast Cancer Res Treat (2011) 130:711-724 DOI 10.1007/s10549-011-1722-9
http://www.ncbi.nlm.nih.gov/pubmed/21904884
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