At a glance
- Give your partner as much time as she needs.
- Give yourself as much time as you need.
- Find other outlets if you’re frustrated – eg masturbation.
- Be aware that your partner’s pleasure centres may have changed.
- Be aware that your partner’s physical appearance may have changed
- Try new things.
- Be gentle with each other.
- Hormone treatment may bring physiological change – reduced lubrication, weakened vaginal walls
- Check with your care provider if it’s OK for you and your partner to have sex.
- Check if pregnancy is a risk.
Jen and I have always had a mismatched sex drive. That’s to say, I regularly wanted sex and she was happy to go months or more without. That said, she could barely go a day without a cuddle. It took years for us to reconcile that difference…that is, for me to get used to not having sex as often as I’d like….
All joking aside, sex is almost always good when it happens and we’ve both always tried to satisfy and please each other.
Sex halted on the days running up to the diagnosis (understandably) and stopped almost entirely thereon in. But Jen and I have never been closer emotionally and rarely as intimate as we are today. She’s…we’re…still healing as I write these words and I can say that we haven’t had sex for over a year now, but my perspective has changed. Utterly. While sex was never the be all and end all of our relationship, it was an important component. Hell, it still is. But in the great scheme of things it doesn’t matter that much. What matters is that I still have Jen by my side (or in front of me) at the end of this process.
Suffice to say, sex with your partner will be fraught with difficulty, if not outright impossible initially and you’ll be experiencing probably the longest sexual dry spell(s) of your relationship so far. The most important thing you need for this part of the journey is understanding so you can give your partner as much time and space as she needs. It’s fine for you to masturbate to get you through this dry patch. I mean, it’s fine if you masturbate whenever (as long as it’s not, you know, in public), but you get what I mean.
During treatment, sexual intimacy beyond cuddling is likely to be a complete no-no. If there is to be any sex, it should be initiated by your partner, not you. My advice would be not to ask or even think about trying to initiate sexual intimacy. However, that doesn’t mean that there can be no intimacy at all, just not the sort you’re probably used to as a couple. During chemo, for example, your partner is going to be tired all the time, possibly nauseated, probably in pain and feeling completely stressed as she tries to focus her efforts on getting through the treatment. Even as a cycle comes to an end, she’ll be looking to the next round and her head probably won’t be in a good place emotionally.
Of course there will always be exceptions to the rule, but the general rule is: people don’t want to have sex during chemotherapy, radiotherapy or before, during or after major surgery.
When your partner is ready to restart love making, there are several possible issues you may need to consider.
Hormone Therapy
If hormone therapy is used to induce premature menopause, you’ll need to keep in mind your partner may not produce much or any natural lubrication. You may have used this as an indicator of her level of arousal in the past. Be assured this dryness going forwards does not mean she isn’t aroused and you can be sure of this by using other cues, like body language, facial expressions, breathing and sound. Making sure you have a tube of safe, water-based lubricant to hand will make love making pleasurable for you both if there is to be penetration of any kind. You can get different flavours, colours and even sensations nowadays to improve or prolong the experience.
Another thing to consider where hormone therapy is in play is that the vaginal walls may be weaker. Oestrogen has a direct influence in both lubrication of the vagina but also on female sex organ health in general – this includes muscle strength internally. This can lead to prolapse of vaginal walls if care isn’t taken, so you need to be gentle and considerate (I mean, you’re both of those things already, right?). That doesn’t mean you can’t have fun and enjoy each other.
Body
Following surgery and radiotherapy, your partner’s breasts and/or surrounding tissue are/is likely to range from tender to completely untouchable, so you’ll need to cater for this. Nerve damage is another factor where the breasts are concerned and it may be that the pleasure centres your partner had on and around her breasts are now gone. Completely. It may even be there’s no sensation at all or even that breast sensations are now unpleasant.
In Jen’s case, she had both breasts removed, including her nipples, then reconstructed. This left scarring, changed the shape radically, made them firmer (bonus!) and left her without nipples or sensation in either of her breasts. It’s possible to have the nipples reconstructed, tattooed or even stuck on (I know, stick on nipples! – guilty confession…I laughed when the breast nurse first said it) but this is ENTIRELY your partner’s choice. If the nipples are removed and reconstructed, note that there won’t be any sensation in them for your partner, so they’ll be there entirely for visual appearances.
You also need to consider changes in your partner’s body image – both in terms of how you see her, how she thinks you see her and how she sees herself. These are important distinctions. Personally, I just reprogrammed my brain to love Jen’s new look even though she wasn’t happy with how she felt physically. But the reality is, no matter how skilled the surgeon, scarring is inevitable at some level and this can impact on how you see things. Body change can be something as small as a lumpectomy scar, all the way through to bilateral mastectomy with no reconstruction. These changes in shape can and will directly affect your respective sex drives to greater or lesser degrees, so take steps to mitigate this. It really is possible to embrace and incorporate these changes into your love making. If it’s a major issue for you, don’t forget you can always start in the dark for the time being while you both get used to the new normal.
Try new stuff…and old stuff… and find what works for you both. You can use this change to perhaps become more adventurous. Hell, you could even give romance a go! On a personal note, blindfolds, sweet foods and a ‘mouths only policy’ can be great fun. If you’re not an imaginative or creative person, books abound on the subject, ranging from the Karma Sutra, to books specifically about cancer recovery in relation to sexuality.
There’s also an excellent therapeutic process to reignite sensuality called ‘Sensate Focus’. It’s a multi-step process whereby you explore each other’s bodies – initially ignoring sex organs – that will help you connect, rediscover old pleasure zones, eliminate defunct zones and find brand new ones. It worked well for Jen and me. It might work for you too. There’s a lot of literature about it online if you want to check it out.
Don’t forget you can also maintain intimacy during treatment by doing things like helping your partner keep an eye on her overall health (be it breast or otherwise) as well as assist with the application of gels, creams and medicines. Even simple things like changing dressings will show her that you’re not bothered by the change in her appearance – it depends on the type of relationship you have with each other of course and it may not need maintenance to that degree, though don’t let that stop you from helping your partner!
Trust is essential to mutual intimacy, so helping your partner while she’s receiving treatment and recovering will help keep, if not deepen, the strength of the bond between you.
Communication is also key to a healthy relationship – make sure your partner feels comfortable unloading on you while she goes through treatment. If you can, try to keep from unloading all your emotional burdens on your partner – certainly while treatment is underway – then build up gently as your partner heals so you’re both sharing each other’s emotional weight.
As with so many things on a journey like this, it may transpire that you’re not equipped to resolve issues that you face – relationship issues can be particularly tricky to unpick – so do always consider seeking relationship counselling or therapy to help with getting things back on track.