Understand · Sex + Relationships
The short answer on talking about sex after breast cancer
Talking about sex after breast cancer usually works best when you say the awkward thing plainly and agree in advance what you will and won't do. Partners are often afraid of hurting you, and you may be afraid of disappointing them. Getting to know your changed body first, including what feels good and what's off-limits, makes those conversations easier.
What to know about talking about sex after breast cancer
- Your partner is probably scared too. Fear of hurting you is common.
- Agree on limits first. Knowing touch does not have to lead to intercourse helps you relax.
- Sex can change shape. It does not have to be spontaneous or include penetration to count.
- Know your own switches. What feels good, numb or off-limits now.
Part of Babette's series on sex after breast cancer. For a founder's view of intimacy after surgery, read Jasmine Jones's Sex and Intimacy After Breast Cancer.
How do you feel at home in your body again after breast cancer?
Slowly, and usually on purpose. A UK guide by sex therapists and cancer nurses suggests looking at your changed body, in a mirror, for a little longer each time until the first shock fades, then touching it and noticing what feels pleasant, numb or off-limits. It calls these your "on" and "off" switches. Once you know them, you can tell a partner.
Presenters at a 2024 National Comprehensive Cancer Network (NCCN) meeting listed the kinds of thoughts that get in the way: "I'm damaged goods," "sex is for healthy people," "if we can't have sex like we used to, what's the point?" They're common, and they're not facts. A therapist who works with people with cancer can help with them.
How can you talk to a partner about sex after breast cancer?
The UK guide suggests saying the awkward thing plainly: "I'm worried it will hurt," or "I've been avoiding sex and I want to explain why." It suggests agreeing beforehand on what you will and won't do, because knowing touch doesn't have to lead to intercourse makes it easier to relax into it.
It also suggests letting go of a few myths: that sex has to be spontaneous, that it has to include penetration or orgasm to count, and that it's only for the young and healthy. Many couples find other ways to be close that feel just as good.
Are sexual side effects different for LGBTQIA+ women?
The physical effects are much the same, NCCN presenters said, and so are the treatments for vaginal symptoms. What differs is what you need help with. Not everyone has penetrative sex, and a clinician shouldn't assume. For more, see Is Breast Cancer Different for LGBTQIA+ People?
What if you are single and dating after breast cancer?
NCCN presenters said single women's concerns often center on dating, deciding when to tell someone, fear of rejection and sex with a new partner. The UK guide's advice: you don't have to wait until treatment ends to date.
Questions to ask your clinician about intimacy after breast cancer
- Is there a counselor or sex therapist who works with people with cancer?
- Is couples counseling available through my cancer center?
- Are there parts of my body I should protect during sex while I heal?
- Where can I find support for dating after cancer?
More from Babette on sex after breast cancer
- Why Does Breast Cancer Treatment Change Your Sex Life?
- What Helps Vaginal Dryness After Breast Cancer?
- Is Vaginal Estrogen Safe After Breast Cancer?
- Why Does Sex Hurt After Breast Cancer?
- Where Did My Sex Drive Go After Breast Cancer?
- Is It Safe to Have Sex During Breast Cancer Treatment?
- Sex and Intimacy After Breast Cancer, by founder Jasmine Jones
Sources: Ballinger, Reese and Ratner, Issues with Sexuality and Sexual Function in Patients with Breast Cancer, National Comprehensive Cancer Network 2024 Breast Cancer Congress (February 2, 2024); Brandenburg, Grover and Quinn, Intimacy & Sexuality for Cancer Patients and their Partners (UK, 2010). This article is general information, written in Babette's own words, and is not a substitute for advice from your care team.
