Sex, Intimacy, and Metastatic Breast Cancer

A metastatic breast cancer (MBC) diagnosis brings many physical, mental, and emotional changes. Sex and intimacy will also likely look different, now and in the long term. It is still possible to have a safe, fulfilling sex life with cancer. It will take patience, communication, and changes in how you approach sex.

How metastatic breast cancer affects sex and intimacy

Cancer treatments like chemotherapy, hormone therapy, and surgery cause side effects that can impact sex and intimacy. The illness itself also takes a toll on your body and mind. Here are some of the ways MBC can change your sex life:^1-3

• Vaginal dryness, which makes penetration painful
• Erection issues
• Lower sex drive
• Low self-esteem resulting from hair loss, changes to your breasts, and surgery scars
• Anxiety
• Depression
• Hot flashes
• Weight changes
• Extreme tiredness (fatigue)

Communicating with your partner

An MBC diagnosis affects both you and your partner. They will need time to process the news and adjust to life with a loved one with cancer. Sex and intimacy are unlikely to be the first thing on your mind after a cancer diagnosis. But when you are ready, start with open and supportive communication.³

First, find somewhere outside of the bedroom to talk. Share your feelings with each other, even if it is uncomfortable. Your and your partner will best be able to support each other’s needs through honest and transparent communication. Talk about how sex and intimacy will be different and ways you can adapt. Then, take it slowly and gradually ease into intimacy.³

Sex and intimacy with metastatic breast cancer

Having metastatic breast cancer does not mean the end of your sex life or intimacy. There are ways you and your partner can still have satisfying sex:^4,3

• Lubrication – If vaginal dryness causes painful sex, try a water-based lubricant. It will help make penetration more comfortable.
• Try different forms of intimacy – Explore other ways to get pleasure and satisfaction for you and your partner. Intimate cuddling, massages, and mutual masturbation are all possible options.
• Manage emotional concerns – Anxiety and worry can make it hard to relax enough to be intimate with your partner. If these feelings linger, talk to your partner, a trusted friend, or a family member. It may also be easier to confide in a counselor.
• Do what makes you feel most comfortable – This could mean wearing lingerie or a prosthesis. Or, you may be ok showing your partner the changes to your body. It is all about your level of comfort.

Talking to your doctor about intimacy

Sex and intimacy are not routine topics during a doctor’s visit. You may not know how to approach the subject with your healthcare provider. When asking for help with changes to your sex life after an MBC cancer diagnosis, keep a few ideas in mind to help kick off the conversation:⁵

• First, make sure your doctor’s office or hospital is knowledgeable. It should have all types of resources concerning metastatic breast cancer and sex.
• Let your medical team know that your sex life is essential so they can pay attention to your needs.
• Share as many details as possible about the sexual changes you are having. If you are concerned about more than intercourse, be clear about that. You and your doctor can then work together to come up with solutions.