Physically and emotionally, you may feel far from sexy right now. Here’s how to change that.

Whether your breast cancer treatment involves surgery, chemotherapy, radiation, medication, or perhaps even all of these, there are a lot of very valid reasons sex may not be doing it for you right now.

It’s very common to lose your sex drive during treatment, says Dr. Kristen Carpenter, PhD, director of women’s behavioral health and assistant professor of psychology in obstetrics and gynecology at The Ohio State University.

Not only are you dealing with potential physical effects like nausea, fatigue, and muscle aches, but there’s also an emotional component that can dampen libido.

“Sexual health struggles are normal during any type of cancer treatment, especially because people start putting pressure on themselves about what they should want and should be doing,” says Carpenter.

“For women with breast cancer, there’s an added layer of how they’re seeing their feminine identity, and likely dealing with changes to that,” she says.

Although it may be tempting to simply hit the sexual “pause” button until you’re way past treatment, there are some benefits to maintaining your sexual health during treatment.

How you see yourself

Your sexual identity is part of who you are, Carpenter says — just as much as other ways you perceive yourself as a friend, parent, daughter, or wife. It’s an important aspect of seeing yourself as a vibrant, engaging, self-loving person.

You may not feel like that at all right now, but just tapping into that identity can be helpful for remembering that you’re not your cancer.

There’s so much more to you than your diagnosis and treatment, and your sexual self is part of that multilayered you.

Relationship health

If you have a boyfriend, girlfriend, spouse, or significant other, it’s likely that your partner is helping with your care in many ways right now.

While that’s important, it’s very common for roles to shift during treatment. You may feel less like romantic equals and more like a patient and caregiver.

“This role change is normal, but it’s a difficult thing for many couples when it comes to intimacy,” says Carpenter. “Focusing on putting some romance and intimacy back in can help alleviate that feeling of making everything about cancer, treatment, and caregiving.”

Even if you want to rev up your libido, it’s likely there are some factors related to treatment that could be thwarting that effort.

Here are some top reasons you might be struggling, according to Jack Jacoub, MD, medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, California.

Dryness

When you’re in treatment, your hormone levels can change, and that can lead to vaginal dryness that could make sex painful.

Side effects

There’s a range of treatment side effects that might be challenging, from loss of stamina and fatigue, to aches and pains, to “chemo fog” that’s affecting cognitive function.

These can all add up to feeling less-than-enthusiastic when it comes to intimacy.

Appearance

Whether you’ve had a mastectomy, are going through hair loss, losing weight, or experiencing other physical changes during treatment, it can be difficult to keep seeing yourself as a sexual being.

Stress

Cancer treatment can feel overwhelming and disheartening. The uncertainty about what’s to come — or whether certain treatment side effects will get worse — can make anyone feel stressed.

It can be tough to feel that lighthearted zest for intimacy in the midst of that feeling.

If you’re in treatment and haven’t been intimate for a while — and you’re finding yourself in the caregiver/patient role with your partner — it can be very challenging to come roaring back.

Fortunately, sex is not an all-or-nothing pursuit. In fact, it doesn’t even have to involve sexual activities.

Here are some suggestions that can help:

Talk with your care team

Yes, it may feel embarrassing at first, but this is part of oncology care — and part of your health.

Jacoub recommends talking about what your “baseline” or “normal” is like in terms of how often you had sex or were intimate before cancer, and what your challenges are now, both physically and emotionally.

You can also consider talking with a therapist who specializes in the unique challenges people with cancer face. You can often get a referral through your oncologist’s office.

Explore products that can alleviate dryness

This is helpful not just for intercourse, but in general, Carpenter says. Many breast cancer treatment options cause vaginal dryness and this can be demotivating when it comes to intimacy.

There are numerous options, both prescription and over the counter, that can act as lubricants and also moisturize vaginal tissue.

Focus on other kinds of intimacy

Intimacy isn’t just about sex. Try focusing on cuddling, kissing, hugging, or other forms of closeness if intercourse or outercourse isn’t working for you at this time, says Carpenter.

Verbal encouragement, like telling each other “I love you” every day and flirting or making suggestive, fun comments, are other non-sexual ways to boost intimacy, she says.

This will help you and your partner get back to seeing each other as romantic partners first and foremost.

Don’t let self-care lapse

It’s common to gravitate toward less self-care during breast cancer treatment, says Carpenter. You may feel yourself having the urge to skip your normal skincare routine or opt for a pajamas-all-day approach — and who could blame you?

But keeping up routines like showering, dressing, brushing hair and teeth, and exercising are all part of feeling good about yourself.

Once you’ve eased the physical issues that come with rediscovering intimacy, and slowly build back up to being romantic and loving with each other, you may find your libido’s pilot light has been relit.

But if it hasn’t yet, then that’s OK, too, Carpenter says.

“This is a multilayered issue that’s far more complicated than many people may think,” she says. “Just take it one step at a time. Identify what’s getting in the way for you and then address those issues one by one. This shouldn’t feel like pressure; it’s about pleasure. Everybody’s experience is different, and you just need to keep focusing on what’s making you feel good.”


Elizabeth Millard lives in Minnesota with her partner, Karla, and their menagerie of farm animals. Her work has appeared in a variety of publications, including SELF, Everyday Health, HealthCentral, Runner’s World, Prevention, Livestrong, Medscape, and many others. You can find her and way too many cat photos on her Instagram.