The chemotherapy drugs used to treat breast cancer can change how you feel sexually and affect your reproductive health. But, that doesn’t mean having sex is off the table. There are also things doctors can do to preserve your fertility.

Your individual experience will likely depend on the type of breast cancer you have and your chemo treatment plan. Knowing what to expect can help avoid some of the frustration later if you experience unpleasant symptoms.

Physical changes

Chemotherapy drugs can cause a variety of side effects. These can affect your sexual health and desire.

Whether or not you experience side effects — as well as their intensity level — depends on a few factors, like the type of chemo drug and dosage, your age at the time of treatment, and how advanced your cancer is.

Sex drive

During treatment, you may notice some changes in the way your body feels and your desire to have sex.

Even if your doctor says it’s safe to have sex during treatment, it’s also perfectly normal not to want to have intercourse if you’re not feeling up to it. General chemo side effects, like nausea, tiredness, and weakness, can take away both your energy and desire for sex.

Other side effects that may impact your sexual health include:

Most of the side effects will go away after treatment ends. In the meantime, there may be things you can do to find relief. For example, over-the-counter, water-based lubricants or moisturizers can help with vaginal dryness.

To help prevent yeast infections, wear loose clothing and cotton panties to keep away moisture in the vaginal area. Talk to your doctor about your symptoms. They can also prescribe creams to treat the infections.

Fertility

Because chemotherapy drugs can be harmful to a developing fetus, doctors don’t recommend getting pregnant during cancer treatment. In some cases, women are advised to wait until six months after chemo is over.

If you have plans to become pregnant in the future, tell your doctor before you begin treatment. Many chemotherapy drugs can damage the ovaries or eggs and stop a woman’s menstrual period.

But there are certain drugs that are considered to have a low risk of damaging eggs. Your doctor may be able to recommend a treatment plan that’s designed to have less risk to your eggs.

For some women, fertility comes back after chemotherapy. For others, menopause may be permanent. Your doctor can refer you to a fertility specialist who can let you know the best options for increasing your chances of getting pregnant after your treatment ends.

Emotional changes

Physical symptoms are not the only thing that can affect your sexuality during chemotherapy. Your emotional well-being also plays a big part. If you’re feeling stressed and anxious during or after treatment, having sex might not be high on your priority list.

Coping with all of the issues that come with a breast cancer diagnosis is difficult. Stressful days can easily become another side effect that requires your attention.

Remember to take of your emotional needs. Practicing relaxation techniques, like meditation, and self-care might help your sexual desire return.

Many women struggle with their body image as they go through chemotherapy. Body changes from surgery and losing your hair can take a big emotional toll on your self-esteem. This can also make sex a low priority.

But while your physical appearance may be changing, you’re still the same person. If you feel you need help coping with stress, talk to your medical care team. Connecting with a support group of women who are going through the same thing can also be helpful.

You and your partner

There might be times when sexual intercourse is too uncomfortable or you’re just not up to it. But this doesn’t mean you have to stop being intimate. Talk with your partner about other ways of giving and receiving pleasure, like touching and stroking.

Sometimes, just cuddling can be satisfying. Ask your partner to give you a back rub or foot massage and then return the favor. Holding hands and watching a movie also shows intimacy.

The most important thing is to talk with your partner. Open and honest communication is the best way to get through this tough time together. Couples coping with breast cancer who discuss their problems openly and express their feelings in a positive way have fewer sexual problems.

Many couples develop a tighter and more intimate relationship during this time when they talk openly. Try these tips to help communicate and stay intimate with your partner:

  • Ask how your partner feels. Being a caregiver to a sick loved one is stressful. Let your partner know that expressing their frustration is normal too.
  • Try something new. Start a new hobby you can both enjoy as a couple. Whether it’s learning a new language or how to cook, chances are you’ll both enjoy spending quality time together.

If you’re still having trouble communicating, don’t hesitate to talk with your medical team’s social worker or ask for a referral to a counselor.

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