What follows are reports from two women who have breast cancer. These are from the new 5th edition of the Guide To Getting It On. We will add the accounts and advice of other readers as you send them.
Also, additional tips, suggestions and resources are listed below.
Here's the first hand account of a 37-year-old woman who is also a reader of The Guide:
Treatments for cancer can cause discomfort, fatigue and intense pain. Still, it's possible to be sexual throughout treatment, just differently than before.
Self-pleasure through masturbation is easiest because you set the pace. Try masturbating even if you have a partner because then you can guide them as to what feels best. I started with self-pleasure for sleep and pain relief a few days after surgery. Later, masturbating in front of my partner also helped be a turn-on at times when I didn't feel up to active sex.
Relaxing with a bath set the stage, lighting a few candles in the bathroom for mood, then a warm tub filled with epsom salts to relieve aches and detox skin. I used lots of lube for self pleasure. I started this bath ritual about a week after surgery, keeping water away from the scar area and drainage tubes until healed.
I talked with my best friend about sex and body image. She said, "You know, no man has ever pursued us for our fabulous cleavage. We both have small breasts, so we are beautiful and desirable for other reasons," and then she gave this wonderful dirty chuckle.
Imagination helps create sexuality beyond what your body is actually capable of expressing at the moment. Erotic talk and guided fantasies help me meet my partner's sexual needs. Often, I put my head on his chest and cup his balls and tell erotic tales when I don't have energy to do more. He touches himself and is happy because we are close.
Tenderness is now more important to me than carnality. My former enjoyment of raw fucking just faded away. I think my partner misses the erotic she-beast who morphed into a cuddle-kitten.
During treatment, I started using light taps and code words to signal when I needed to move, stop or pull away due to pain or discomfort. My favorite position became the couvade, or twisting my pelvis to rest on one hip for side entry, legs sandwiched around his, and supported by lots of folded towels and an extra sheet. The extra towels served another purpose. Nausea and incontinence are common responses to chemo and radiation. Having the towels there to wrap around made me feel more confident about bed play.
Lube is hugely important. Drink extra water a few hours before sex. All mucosal membranes (especially the mouth) get sore with chemo and radiation, so during treatment, I added plastic condoms, even for oral sex, to help prevent any infections while my immune system was down and out. Semen made my skin burn and get rashy, so I cleaned up fast. I learned that I liked not having a bush of pubic hair so I continue to trim it even after it started growing back. Being bare makes me more responsive.
Alcohol upset my stomach, but pot soothed my nausea and made me feel relaxed enough to be sexual. I think medical marijuana should be legal for cancer patients to help sexual healing and getting a groove on as well as combatting nausea.
Lace is itchy against the scars on my chest and under my arms where lymph nodes were removed. I won't wear underwire bras anymore because they are too constricting. But I do put on cute camisoles that are soft and stretchy enough to take off without tugging.
I hate cancer, hate having lost a breast. I went through a horrid jealous phase, envying other women their whole breasts, their health, their fertility (treatments put me into early menopause). But that's a draining response, so I don't dwell on it. Now, I just try to appreciate beauty when I see it, period.
Sexual confidence comes and goes more readily. Sometimes, I don't like being exposed, and will drape a sheet over me during sex to cover my scars. My partner has to be patient with that. If I have a hot flash during sex, I'll ask for oral sex instead, so there is a lot of back-and-forth during sex. Continuing joint pain makes me move positions a lot, so I use small pillows and bolsters for support. Yoga helps with pain management, too.
Interestingly enough, I now get aroused through massage of my inner foot arches. It's nice to have discovered a new erogenous zone to take the place of lost nipple sensation. A foot massage is a sweet way to get started relaxing and wiggling around in my partner's lap; it's fun.
My lover is an amazing partner who helped me do all the hard stuff: shaving my head when my hair began to fall out, going with me to meet the doctors when I felt afraid, or offering a helping hand to steady me as I stepped into the tub or shower. I am lucky to have such love and and care.
The following is from another reader who was diagnosed with breast cancer at a very young age:
I was diagnosed with breast cancer at the age of 31. My boyfriend asked me to marry him ten days after that. Knowing that he still loved me and wanted to marry me after hearing such devastating news was so incredible to me.
I elected to have a double mastectomy which was a scary thing to do because the thing that defines you the most about being a woman is your breasts. It was strange thinking that the thing that I had criticized the most about my body was now feeling like the most precious part of it. I immediately had reconstructive surgery after my double mastectomy so I never experienced life without breasts, but the ones I woke up with were made of silicone and had no nipples. My skin was ultra sensitive, and at first I didn't want to wear a shirt let alone be touched. After a few days I had no sensation in my breast area at all.
Before my surgery I had LOVED having my nipples played with and I used nipple clamps frequently. It was so devastating to lose such an important part of my sexuality to cancer. It was hard to imagine enjoying sex as much without my nipples and the sensations they had produced in my whole body - a tingle that goes from your head all the way to your toes. I felt so ugly and disfigured. I really couldn't fathom that my fiance would even want to have sex with me. Proving to me yet again what a wonderful man he is, we ended up having sex just a few days after I was discharged from the hospital. It was one of the most therapeutic parts of my sexual healing. Just seeing the devilish sparkle in his eyes as he looked at me with so much love and longing warmed me from the inside out!
It's been almost two years since my surgery and I feel sexy despite my cancer and reconstructed breasts. My husband has continued to be turned on by me and we've found other areas of my body that are as sensitive (if not more sensitive) than my nipples used to be. It really goes to show that being sexy is more a mental attitude than a physical trait and that facing your fears about sex after such trauma can be a very positive experience."
When people are diagnosed with certain terrible diseases, or tragic things suddenly happen, they sometimes try to blame it on things they have done.
They might interpret their cancer as punishment for past sexual enjoyment, or for masturbation, incest, abortion or anything we might have felt guilty about. It is easier for us to believe that there was a cause of the cancer such as masturbation than to realize that bad things can happen in a totally random way.
It often makes us feel too helpless to admit that there was nothing we did to cause the cancer or the tragedy. That would mean the world is totally random with no regard for human effort or struggle. So we create a personal myth that allows us to place the blame on past forms of sexual enjoyment.
In our culture, sexual pleasure is still a dangerous commodity with dangerous overtones. It is one of the first things we toss overboard during life's storms. We forget that it's as much a part of us as the need to eat and breathe.
"There are two big taboos in conversations about breast cancer. One is death. The other is sex."
—from page p. 171 of Marc Silver highly-recommended book Breast Cancer Husband, How to Help Your Wife (and Yourself) Through Diagnosis, Treatment and Beyond.
A number of the suggestions and tips below are from Marc Silver's book. It is an excellent resource for any husband or boyfriend of a woman with breast cancer. You are encouraged to buy it or get it from your local library. Other suggestions are from readers of the Guide To Getting It On!, as well as from other sources. We will post new suggestions as you send them.
—Silver mentions that a husband is often concerned about flirting with his wife, for fear she will think he is pressuring her for sex. But not flirting with her can easily become a signal that she isn't sexy anymore. Or his hesitancy to touch and play with her remaining breast if she had a masectomy can also become a signal to her that she is no longer attractive to him. Or he might fear hurting her if she's got drainage bulbs hanging out of an incision following surgery.
The fact is, she has breast cancer, not dementia. She knows her partner's sexual desire didn't suddenly melt away with the discovery of her cancer, and the chances are, hers didn't either. At some point, hopefully sooner than later, the two of you need to talk about sex. Get your signals straight that it's OK for him to pursue sex with her, and for her to pursue sex with him, and it's OK for either of you to say "yes" or "no" without feeling uncomfortable about it.
—Adjustments will need to be made in the way you have sex, but maybe that will be one of the hidden plusses in all of this. Maybe you'll start exploring new ways to enjoy sex with each other, in addition to the old.
—Hopefully you'll click on the "Sex & Brain Cancer" link on the sidebar to see how one couple with cancer uses sex to feel closer in times of fear and distress.
—Radiation can do a number on the skin of a woman's chest. If feels OK, it might be a nice way for the couple to keep physically connected for her partner to rub lotion on her chest a couple of times a day.
—For some women, chemo can make intercourse extremely painful. No matter how wet she might have gotten before, have a couple of different kinds of lube handy for when you start having intercourse (each has a different feel, which is why you should try a couple of different brands). Be sure to coat both the head of the penis as well as the insides of her vagina. Otherwise, if she has painful intercourse, it might start a nasty chain reaction where her vagina automatically tenses up whenever it senses an erect penis in the neighborhood.
—If you have access to a swimming pool, swimming pool sex can be really nice. [As is mentioned elsewhere in the Guide To Getting It On, sex in water can actually end up being dry sex because the water can wash out a woman's natural lube. An excellent work around is store-bough silicon based sex lube. Coat your respective genitals with it before getting wet, so to speak.]
—Sexy, short lingerie like a silk camisole or peignoir can help her feel less conscious about any missing chest real estate.
—If she's receiving chemo and she feels like having sex (which might not be too likely) the man should proably wear a condom for the first day or two. That way, he won't risk getting a rash on his penis from any of the chemo that is in her vaginal lubrication. For the same reason, he should avoid giving her oral sex for the first couple of days after she receives chemo, unless he's got a tumor himself and you're trying for a two-for-the-price-one thing.
—Think about her physical state now as opposed to a few weeks before her diagnosis. If she's undergoing chemo and has had surgery, chances are she's bald and missing a big part of what Hugh Heffner tried to convince the world is the most sexy part of a woman's body. She may have scars that she didn't have and she isn't exactly feeling like she did when she was twenty and the tease of the town. While it would seem weird to her if you didn't acknowledge the new realities, this is also no time to hide your sexual desire for her. And if she's way too tired from chemo to even think about sex, ask if she'd like a foot rub or if she'd like you to massage her fingers.
—If you end up going for months when she doesn't want sex and you've been masturbating a lot, still try to keep a physical and sensual connection. This will make it easier to reconnect sexually when the effects of the chemo and/or radiation are starting to fade.
—One of the biggest casualties to breast cancer can be romance. It's hard to be romantic when so many new and mostly unwelcome things are suddenly intruding on your lives. Yet good luck having sex without romance and affection. Keep in mind that if you put romance on hold during the worst of your cancer saga, you'll need to rekindle it as soon as you and she are able.
—Life can have its unfortunate contradictions. One woman who loves her public hair might lose it all during cancer treatments, while another who goes through the hassle of shaving herself bare every day won't lose any of it!
—When there is sexual desire but little enegry, think about ways to make adjustments. For instance, what if you find a comfortable position where he can have his penis inside of her vagina without thrusting while she uses a vibrator? He might then need to masturbate after she's had an orgasm, but you still get the sexual and physical intmacy without her needing to expend much energy.
—If a woman is feeling bad about the way she looks and particularly unsexy, she should try not to assume assume that this is how her partner feels about her. And he should know that even if he still finds her to be sexually desirable, she might be so turned-off to her current condition that she assumes he is as well. This is one more example of just how important it is to talk to each other about sex.
—If her vagina is too tender to handle but a minute or so of intercourse, she can get him close to coming with oral sex or by hand, or he can jerk himself off until he's just about to come, and then they start intercourse. Also, a finger on or in his anus during intercourse might help him to come sooner.
—If she is disposed to urinary tract infections, drinking lots of water and peeing right before and after intercourse can be helpful.
—You might need to change your thrusting depth and rhythm during intecourse. Experiment and give each other a lot of feedback.
—Birth control is a must for any woman who is not past menopause. Check with your physician(s), as they probably won't want you using hormonal methods.
—Squeezing your breasts, sexual touching, and sexual activity will not spread cancer or impact your recovery in a negative way! Having orgasms does not alter or negatively impact your estrogen balance. Being wet sexually and having orgasms are just as good for you during and after cancer treatment as before.
—It's perfectly acceptable in our society for the person with the cancer to be angry about it, but not so for her partner. Yet unresolved anger can get in the way of having sex, especially when the person without the cancer is angry and feels guilty about being angry. This is the kind of thing that a therapist who deals with cancer-related issues can be very helpful with.