10 things you need to know about sex and breast cancer

It's normal to feel worried about intimacy but you CAN have an enjoyable sex life​ after treatment

the good news is that most women are still able to have great sex after treatment. Here are some things you should bear in mind:

1. Communication is key 

It's not always easy to talk about sex, but finding the right environment for both of you is essential. You need to consider how you share sexual pleasure and what has changed within your relationship.

Explore new ways of sexual intimacy, such as sex without intercourse, using sex toys or bondage to explore each others bodies, read erotic fiction or watch films to increase arousal. Tell each other what feels good and what is uncomfortable or painful.

2. Tell your partner where to touch

Breasts play an important part during sex, especially if you enjoy having them stimulated. Losing a breast or changes to a breast through surgery and radiotherapy can impact upon the way you feel about being a woman and your sexual satisfaction.

It can be helpful to your partner if you tell them where and how you would like to be touched, or even guide their hand so they know how to touch you and what pressure they can use.

If you don't like having your breasts touched, try other parts of your body such as neck, ears, lips, thighs and genitals for sexual stimulation. Try massaging each other with scented oils or take a long, hot bath, soaping each other all over. These simple techniques can help you to reconnect sexually.

3. Confronting body changes is important

Many women mourn the loss of their breast, others rejoice that it has gone with their cancer. 

Confronting the physical changes to your body is important and will enable you to feel confident about how you look. Involving your partner in this process can help too.

Some women choose to wear a prosthesis in their bra prior to having reconstructive surgery. The choice of underwear for women who have had a mastectomy is wide and your breast care nurse can put you in contact with a specialist underwear adviser trained in helping you to find the most suitable lingerie.There are several specialist lingerie websites, including Love me and my secret that have gorgeous bras and matching knickers, especially for post mastectomy.

If you do opt for breast reconstruction, you may end up with better breasts that you used to have!
You can even have your nipple tattooed onto your new breast if it has been removed.

4. Great sex doesn't have to involve penetration 

Gradually building up to penetrative sex can be fun. Try masturbating each other using your fingers, sex toys or with your tongue.

If your vagina feels dry or painful, use a good quality lubricant to nourish the genital tissues and make the whole experience feel pleasurable.

Invest in a sex toy for yourself and your partner so you can both enjoy the pleasures of masturbation. Try a clitoral vibrator or male masturbator such as a Fleshlight.

5. Take the time to explore what works

Many women being treated for breast cancer find that their libido reduces or disappears completely as a result of their treatment, prolonged fatigue, physical changes to their body, lack of confidence about the way their body looks after surgery or constant worry and anxiety about their diagnosis, treatment and future.

But take time to explore what works for you sexually and seek medical advice if you feel that the problem is not resolving itself. Many medicines for breast cancer can impact upon your libido and a simple change in your drug therapy may reduce any unpleasant side effects.

6. Menopausal symptoms are common

Many of the side effects of cancer treatments can bring about symptoms of the menopause, which can be distressing. Hot flushes, night sweats and vaginal dryness can affect your sexual relationships.

Menopausal symptoms often affect younger women who have had breast cancer, making them mourn not only the loss of their breast but also their sexuality. Counselling can help women find ways of dealing with this. And a good lubricant can help with vaginal dryness.

7. Pelvic floor exercises can do a world of good

Pelvic floor exercises can improve blood flow to the vagina and enable you to relax these muscles during sex and intimate pleasure to reduce pain. Using pelvic floor exercisers can help and involve little effort. Strong pelvic floor muscles can also increase the intensity of orgasms.

8.  Sex toys can help you reach the big O

Treatment for breast cancer can affect the way in which you experience orgasms. You may find it more difficult to orgasm due to tension and anxiety. Drug therapy can cause decreased sensation during sexual arousal, affecting how long it takes you to reach orgasm.

Using sex toys can increase sexual stimulation and help you achieve sexual pleasure in other ways. Many sex toys help women to relax and can create a different sexual experience. Getting your partner to use a sex toy on you can help you to connect, even when penetrative sex is not possible. When penetrative sex is possible, incorporating the use of sex toys on your clitoris can help increase your sexual pleasure and hopefully produce an orgasm.

9. Find positions that work for you

Pain from scar tissue will slowly resolve following surgery and teaching your partner to be gentle with you can help, guiding them where to touch you and what pressure to use. Many partners feel anxious about touching their partners for fear of causing pain and will be more than happy to be told what feels good and where to avoid.

Try experimenting with different sex positions if it feels uncomfortable – using pillows can help support you. This can be great fun as you explore what works for you. Lying side by side in a spooning position feels very intimate and will place less pressure on your body, as will being on top.

10. Take things at your own pace

Fatigue is a common side effect of chemotherapy and radiotherapy. The key is to take things at your own pace: you can take a less active role during sex.

If you feel physically drained in the evening, try having morning sex or sex during the day. Even quickie sex can be fun and may reduce your fatigue. By slowly increasing the amount of physical activity you do, you may have more energy for sex