Understand · Sex + Relationships
The short answer on why breast cancer treatment changes sex
Breast cancer treatment changes sex for most women, and it's usually the treatment, not you. Hormone therapy lowers estrogen, which can cause vaginal dryness, pain and lower desire. Chemotherapy can bring on early menopause. Surgery and radiation change how your chest looks and feels. Worry, fatigue and some medicines add to it. Most of these effects can be treated, but your care team can only help if you tell them.
What to know about breast cancer and your sex life
- You are far from alone. In research cited by NCCN presenters, about 73% of breast cancer survivors reported sexual problems.
- Most women never get asked. Only about 30% say they have talked about sex with their oncologist, though most want to.
- Hormone therapy is a big factor. Its effects can last as long as you take it, often five years or more.
- It is treatable. Lubricants, moisturizers, pelvic floor therapy, sex therapy and, for some women, vaginal estrogen can help.
This is the first in a short Babette series on sex after breast cancer. Each piece answers one question; they're all linked at the bottom. For the emotional side, from lingerie to being touched again, read founder Jasmine Jones's Sex and Intimacy After Breast Cancer.
How common are sexual side effects after breast cancer?
Very. At a 2024 National Comprehensive Cancer Network (NCCN) breast cancer meeting, presenters cited an analysis of 15 studies in which about 73% of breast cancer survivors reported sexual dysfunction. They also cited the SOFT and TEXT trials of hormone therapy in younger women: depending on the drug combination, about 42% to 54% reported vaginal dryness, about 42% to 46% lower desire, and about 24% to 32% pain during sex.
Yet the same presenters cited research finding that only about 30% of survivors had discussed sexual health with their oncologist, even though 80% to 90% said they wanted to. Patients worry about embarrassing their doctor. Doctors worry about embarrassing their patients. Many people assume nothing can be done. Something usually can.
How does hormone therapy for breast cancer affect sex?
Tamoxifen, aromatase inhibitors and ovarian suppression lower estrogen or block its effects. The American Cancer Society (ACS) says hormone therapy can cause hot flashes, vaginal dryness, pain during sex and lower desire, and it singles out hormone therapy as a major cause of lost libido. Because these medicines are often taken for five years or more, the effects can last. For hot flashes, see Hot Flashes on Hormone Therapy.
How do chemotherapy, surgery and radiation affect sex after breast cancer?
Chemotherapy. The ACS says chemo can bring on early menopause, with dryness and thinning of the vaginal lining. Fatigue, nausea, hair loss and worry can push desire down, though it often comes back between cycles or after treatment ends.
Surgery and radiation. NCCN presenters listed pain, scarring, changed or lost sensation, asymmetry, lymphedema and trouble getting comfortable in some positions. For many women, a breast or chest that was part of sex now looks or feels different. If your chest is numb, see Why Is My Chest Still Numb?
Everything else. Fear of recurrence, depression, exhaustion, relationship strain and some of the medicines used to treat them can all affect sex. Most women are dealing with several of these at once.
How do you bring up sex with your cancer care team?
You may have to go first. The ACS says clinicians don't always ask, and they can't help with a problem they don't know about. NCCN presenters noted that NCCN's survivorship guidelines tell clinicians to ask about sexual function at regular intervals, so you're not raising something off-topic.
It can help to tell the office ahead of time that you want to discuss a sexual side effect, so it isn't squeezed into the last minute. Write your questions down. Be specific: "sex hurts," "I'm dry all the time," "I've lost interest and it bothers me."
Who can help with sexual side effects after breast cancer?
Your oncology team is the starting point, but often not the whole answer. NCCN presenters described a team that can include a gynecologist or menopause specialist, a pelvic floor physical therapist, a psychologist or social worker, a sex therapist or sexual health counselor, and a survivorship program. They said counseling and skills-based programs, including cognitive behavioral therapy and mindfulness, have evidence behind them. The American Association of Sexuality Educators, Counselors and Therapists (AASECT) lists certified sex therapists.
When to call your care team about a sexual side effect
- Itching, burning or a thick white discharge, which can mean a yeast infection
- Sores, blisters or warts on or around the genitals
- Bleeding after sex that's more than light spotting, or keeps happening
- Pain during sex that doesn't ease with lubricant
None of these needs to wait for your next routine visit.
If it feels like an emergency, call 911.
Questions to ask your clinician about sex after breast cancer
- Could my treatment be causing these changes, and will they last?
- Which of my medicines could be affecting desire, dryness or orgasm?
- Who on my team is the right person to talk to about sexual side effects?
- Can you refer me to a gynecologist, a pelvic floor physical therapist or a sex therapist?
- Does my cancer center have a survivorship or sexual health program?
More from Babette on sex after breast cancer
- 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?
- How Do You Talk About Sex After Breast Cancer?
- Is It Safe to Have Sex During Breast Cancer Treatment?
- Sex and Intimacy After Breast Cancer, by founder Jasmine Jones
Sources: American Cancer Society, Managing Sexual Side Effects as a Woman with Cancer (accessed October 2026); American Cancer Society, How Hormone Therapy, Chemo, and Immunotherapy Can Affect Sex for Women (revised April 15, 2025); 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); Kariyawasam-Chavez, Breast Cancer Treatment Ends, But The Medication Questions Don't, Pharmacy Times (October 18, 2026); AASECT. This article is general information, written in Babette's own words, and is not a substitute for advice from your care team.
