Sex after a mastectomy is a thorny issue, not just because of the actual trauma imposed on the body by the surgery, but because of a woman’s mental and emotional state following the removal and then reconstruction of her breasts. Depending on how she feels about her body post-surgically, it may take a woman months, if not longer, to feel comfortable engaging in sexual intimacy again.
First there are the physical issues that need to be addressed. Pain from post-mastectomy reconstruction is very real, and that’s not an aphrodisiac. Expect the chest to be sore and tender for many weeks. The reconstruction can take place in steps and continue over a fairly long period of time. There may be a time when you have no nipples, and the surgical scars may itch and cause discomfort. There may be extensive loss of sensation, an off-putting and frightening consequence to post-surgical patients.
Purely physical sensation aside, mostly it is concern about the new constructed breasts and their appearance that cause both partners the most sexual anxiety. Partners need to communicate their reservations and fears to each other. While the woman may be most concerned about her appearance, her partner may be fearful of touching her and causing her pain.
Cancer patients across the board usually suffer a loss of libido. This is no different when recovering from a mastectomy. Chemo and radiation treatments post-surgery have their own unwanted side effects, including nausea, extreme exhaustion, and hair loss. The double whammy of first losing your breasts and then your hair is a tragic indignity and not a great incentive for lovemaking. Post-surgical depression is very common in breast cancer patients in the year following diagnosis. Depression, which often exhibits itself in irritability and fatigue, makes sex unappealing.
On the bright side, you may fall in love with your new breasts. Size-wise, they may be the breasts you always longed for, or they may be just like your old breasts before you had children or breastfed. Another plus is that many women report that although they may have experienced a loss of sensation in places where they had it before, new erogenous areas develop to compensate for the ones that are lost. You may find that you now enjoy having your cleavage stroked, or that touching your clavicle sends a new tingle down your spine.
It may take time, patience and sensitivity to begin to enjoy sex once again after a mastectomy but sexual fulfillment can be achieved if one has an understanding and loving partner and desires the life-affirming value of a satisfying sex life.
Eve Marx writes frequently about sex for ThirdAge.com.