Finding Solutions To An Often Overlooked (But Very Valid) Aspect Of The Breast Cancer Journey
Sexual wellness isn’t always part of the conversation during breast cancer treatment — but it should be. For many women, intimacy becomes a confusing, painful or emotionally charged topic during this time.
If you’re experiencing disruptions to your sexual wellness, know that you’re not alone. And you deserve solutions that help you reconnect with yourself and your body.
While every experience is unique, one thing remains true: your sexual health matters. We explore what survivors wish they had known, what providers want you to understand and what’s available to help you thrive again!
Let’s Talk About It: Sexual Wellness Deserves A Seat At The Table
Breast cancer affects more than just breast tissue. It impacts identity, hormones, body image and personal connection. Yet, many survivors say this topic is swept under the rug.
“You’re not selfish for wanting to feel good in your own body again. Your sexual health is just as valid as any other part of your healing. You’re allowed to ask questions, set boundaries & pursue solutions without guilt.”
-Bess Hagans, Founder of Thriving Beyond Breast Cancer
What Breast Cancer Treatment Does To The Body & Why It Affects Intimacy
Understanding what each treatment does can help you make sense of how your body is responding — and what can be done to support it.
Different Treatments Affect Sexual Health In Different Ways:
- Surgery (lumpectomy, mastectomy, reconstruction): Can affect breast sensation, body image and nerve pathways.
- Chemotherapy: Often causes fatigue, vaginal dryness, early menopause and decreased libido.
- Radiation Therapy: Can lead to localized skin irritation, fatigue and physical discomfort.
- Hormone Therapy: May suppress estrogen, leading to vaginal atrophy, mood swings, brain fog and libido changes.
- Targeted/Immunotherapy: Often milder, but may still disrupt energy levels and emotional balance.
When Your Breasts Don’t Feel Like Your Own Anymore
Surgical intervention — whether partial or complete — can significantly impact how you relate to your body. You may experience loss of sensation, scar sensitivity, asymmetry or simply a changed relationship with a part of yourself that once symbolized femininity or intimacy.
That’s real. That’s valid. And it’s okay to grieve, adapt or even redefine intimacy on your own terms. Some women pursue breast reconstruction surgery or cosmetic breast augmentation, while others seek different avenues to restore their confidence.
There are no wrong answers when it comes to reclaiming your sense of self.
How Breast Cancer Treatments Impact Hormones
Many breast cancer treatments reduce or block estrogen, leading to symptoms that feel alarmingly similar to menopause including mood swings, low libido, vaginal dryness and night sweats. For younger women in particular, this change can feel abrupt and disorienting.
Hormonal shifts also affect lubrication, blood flow and arousal response, making intimacy feel difficult or even painful without support.
Common Sexual Side Effects Many Breast Cancer Patients Experience
- Vaginal dryness or irritation
- Pain during sex (dyspareunia)
- Reduced libido or arousal response
- Delayed orgasm or inability to orgasm
- Fatigue or discomfort in sexual positions
- Increased emotional sensitivity
- Brain fog & issues concentrating
- Difficulty connecting with their own body
Each of these has a reason behind it — and, importantly, potential solutions.
Real-World Tools & Support That Can Help
Sexual wellness doesn’t begin and end with intercourse. It’s about feeling confident, comfortable and connected. There are a range of options that can help you rediscover pleasure, whether you’re partnered or solo.
“I tell my patients that sexual health can be seen as a barometer for overall wellbeing. If changes are experienced after chemo, it’s a sign to look deeper & support the body’s healing process holistically.”
-Courtney Gilbert, PA-C | Sexual Wellness Expert
Products That Can Help Make Intimacy Comfortable Again
- Water-based, pH-balanced lubricants
- Reusable vaginal dilators to gently retrain muscles
- Stimulating gels for arousal
- Vibrators designed for post-menopausal users
- Moisture-rich vulvar balms
- Cooling pillows or weighted blankets for hot flashes or comfort
Nonsurgical Solutions To Enhance Sexual Wellness
- Vaginal Estrogen Therapy: Improves vaginal dryness & elasticity with minimal systemic absorption; often safe for survivors.
- Pelvic Floor Therapy: Strengthens vaginal muscles, improves comfort during sex, reduces urinary incontinence & restores confidence.
- The O-Shot®: Uses your body’s own platelets to increase arousal, lubrication & orgasmic response.
- diVa® Vaginal Laser Therapy: Gently resurfaces vaginal tissue to boost moisture, elasticity & overall sensation.
- Cognitive Behavioral Therapy (CBT): Helps rebuild self-image, reduce anxiety & reconnect with your body & identity.
- Red Light Therapy: An emerging solution that supports cellular repair & blood flow to promote natural lubrication & vaginal tissue health.
- Specialized Wellness Programs: A holistic approach that combines nutrition, movement, sleep & stress support to help restore hormonal & emotional balance.
- Mindfulness & Breathwork: Reduces anxiety, increases body awareness & supports more relaxed intimacy by stimulating the vagus nerve.
[The Importance Of Mental Health During Treatment]
You should always ask your provider or a sexual wellness specialist for guidance before trying a new product or professional treatment.
“Chemotherapy can have a profound impact on the body’s hormone production, leading to vaginal dryness or decreased libido. Lifestyle interventions like stress reduction & targeted nutritional support can mitigate these effects & support the return of healthy hormone balance. You deserve to feel pleasure and connection!
-Courtney Gilbert, PA-C | Sexual Wellness Expert
Sexual Health Is Health
Sexual activity (including self-pleasure!) isn’t just about connection. It can reduce stress, improve sleep, support hormone regulation and elevate mood. One study published in 2021 found that survivors who prioritized sexual health experienced improved emotional resilience and body image over time.
Additional Health Benefits Of A Healthy Sex Life During This Journey
Other studies have shown that oxytocin — released during physical intimacy — may even indirectly reduce pain perception and improve trust in relationships. Another from 2014 suggests that simply talking about sexual wellness with a professional during radiotherapy leads to better psychological adaptation.
So yes, when you’re ready, intimacy can be part of your healing.
How To Talk About It With Your Partner
This can be hard. But it doesn’t have to be perfect.
Let your partner know how you’re feeling, what’s changed, and what you need now. Use simple, gentle phrasing like:
- “I want to feel close, but I’m not sure how right now.”
- “Touch feels different than it used to — can we explore slowly?”
- “I’m figuring out how certain things feel again, and I’d love your support.”
“Compassion, patience & humor can go a long way. These conversations can be awkward! It’s OK to laugh through some of this together. That, in itself, is its own form of intimacy!”
-Bess Hagans, Founder of Thriving Beyond Breast Cancer
When To See A Specialist
You don’t have to wait until it gets “bad enough.” If you’re experiencing pain, distress, confusion or relationship strain due to changes in intimacy — that’s more than enough reason to speak to:
- A gynecologist or pelvic health specialist
- A sexual wellness expert or PA familiar with cancer recovery
- A pelvic floor therapist
- A therapist trained in trauma or identity reconstruction
Additional FAQs About Sex & Breast Cancer Recovery
Is it safe to have sex during chemotherapy?
In most cases, yes but precautions (like condom use) may be recommended, especially when your immune system is low. Check with your doctor.
Will I ever want sex again?
It’s very likely that you will. It may take time, patience, and experimentation, but desire often returns in new or familiar ways.
What if I feel nothing during intimacy?
Nerve damage, hormonal suppression and stress can all play a role. There are physical and therapeutic solutions available to help you readjust and reintroduce sensation.
What if my partner doesn’t understand what I’m going through?
This fear is not uncommon. Consider attending a counseling session together or sharing articles like this to spark deeper conversations.
You’re Not Alone In This — & You Deserve To Feel Good Again!
Sexual wellness is a part of thriving. You deserve support and empowerment every step of the way, whether you’re exploring your identity post-surgery, adjusting to new sensations or rediscovering connection.
About The Authors
Bess Hagans is the Chief Executive Officer of Thriving Beyond Breast Cancer and a proud breast cancer thriver herself. Her firsthand experience navigating the physical, emotional and sexual challenges of treatment led her to establish TBBC — a nonprofit organization committed to supporting younger women with breast cancer through financial stipends, free mental health resources, honest conversations and real-life connection to help patients through this journey.
Courtney Gilbert, PA-C is a functional medicine provider at Donaldson in Columbus, Ohio. With a rich history in women’s health and pelvic floor therapy, she specializes in sexual wellness, fertility optimization and hormone replacement therapy (HRT) treatments. Courtney’s holistic approach empowers women to reclaim their health, confidence and intimacy at every stage of life.
