Talking about sex is difficult in the best times – and especially when things will not be fine. Most will not want to talk to a partner, let alone a doctor. Add breast cancer to the mixture – and this reticence is only increased. One in eight women will develop the disease in life. Most will enjoy active sex life.
But breast cancer surgery can have a devastating effect on body image and self-esteem, while medicines for the treatment of tumors can cause menopause, close libido, and make sex extremely unpleasant. Nevertheless, intimacy is rarely, if at all, discussed during medical consultations. Perhaps women are too scared, or they are too embarrassed to mention it.
They may also be doctors or are simply too focused on survival statistics, not on the quality of life. You see, this is a situation that I have a personal experience from both sides of the counseling table.
44 year old dr. Liz O 'Riordan has twice been treated for breast cancer and has written about her experiences to gain additional knowledge from her daily work as a NHS consultant who specializes in the illness
Dr. O'Riordan said she was 40 years old when she was diagnosed with a photo
I am 44 years old and a consultant for breast cancer surgeons in East Suffolk and NHS Trust in North Essex. The main point of my work is the treatment of women with breast cancer. I'm discussing diagnosis, prognosis, treatment plans and possible outcomes.
But in the past, I rarely, if ever, talk about sexuality, I always assume that the GP or nurse has breast cancer care.
And then, when I was 40 years old, I received a devastating news that I had breast cancer myself. Before that I had cysts when I noticed a new clump on my left breast, I was not so worried, but I checked it anyway. A few weeks later, mammography, ultrasound, and subsequent biopsy confirmed that I had a tumor.
I knew what would happen – chemotherapy, followed by mastectomy and radiotherapy. My tumor was sensitive to estrogen, so I also needed a hormone blocking agent tamoxifen that triggered an immediate menopause.
At that time, I was in denial, struggling to accept the truth about what is going on, notwithstanding sharing it with my loved ones.
Dr O'Riordan said that she married her husband, Dermot, that she had never thought she would get sick when she vowed "in illness and health".
Later, I noticed my emotions in words: I began to write about my experiences on the web and found a new community that shares stories and tips about cancer with honesty, warmth and sometimes humor. In 2016, I wrote a post entitled "We are talking about sex …"
To be honest, it seemed incredibly difficult for me to express it in words, as it is so close to home.
I was married to my husband, Dermot, 54, a surgeon, only a few years ago when I was diagnosed. As most of the married people, we promised that we would love "in diseases and health". But when you say these words, you never think you're going to get sick.
Suddenly, my husband had a wife with a sore, often painful fake chest and a Brillo pillow, which, as a result of chemically induced menopause, night-time washed up the bed linen and dripped in sweat.
Dr. O & # 39; Riordan had a premature and immediate menopause after having had to take Tamoxifen as part of breast cancer treatment.
At some point I even told him to leave me for a woman with two chests and a healthy libido.
What Lizz's husband Dermot says …
Dermot says: 'It's inevitable that in every relationship there are periods when you do not have sex – it's a fact of life.
Throw But cancer throws everything out of the crash.
That's not about not wanting to have sex. And for me, there was no question of whether I was still attractive to Liz, or I still love her. Of course I am.
Your But, when your partner goes through hell, this will not happen. When you have not done this time, it can be embarrassing, unnatural, and not very spontaneous.
It's just a fact of life that your sex life will never be the way it was.
Alone And you can feel yourself, but you just have to mix it up.
Sex If sex is not talked about, sex does not become a new norm.
So, if you do not talk about it, you will never get your sex life again. "
Dermot told me not to stop being so stupid that he loves me and does not go anywhere. And he was really surprised when he dealt with everyone who treated us.
But the fault persisted because I knew that the relationship with a little intimacy was not good. Sex can be a glue that combines steam, but cancer can tear them apart.
After breast cancer, you must physically connect differently because your libido will never be the same.
Last May, my cancer returned to the scar, where my left breast was. After removal surgery and increased radiotherapy, I needed a different hormone blocking agent because tamoxifen did not work.
In order for the new medicine to work properly, I had to stop my own production of the female sex hormone produced by the estrogen produced by the ovaries, so I withdrew my mine in September. In this blog, I wrote about sex: "I'm slowly learning to take a new one."
And I'm still there.
Today, I ask all patients about their sexual life. If you have breast cancer, you may no longer have a problem with sex, and that's fine. But if you want things back on the right path, I can help you – with your own experience as a doctor and a patient.
So, where to start? Well, here is everything I want to know – a guide that should be read by any woman or man with breast cancer and his partner …
Dr. Riordan, on the picture on her wedding day with husband and surgeon Dermot (54), said that it is important that couples talk about their sex life when they are treated with cancer
Accept your body and feel different
Now surgeons can do incredible things. We can remove lumps, leave hidden scars and transform our breasts. If you need mastectomy, your breasts can be reconstructed with an implant (what I had) or with your tissue. But something I did not fully understand until I took care that the reconstructed breast was fully pulsed. My did not feel, so I was no longer an erogenous zone for me.
I did not want to look in the mirror, what should my husband do with this?
When my cancer returned, I had an implant removed and it was even harder to adjust. Instead of my left breast I have more scars and radiotherapy skin lesions.
It's hard to feel sexy when I'm naked in front of my husband. He told me that I still look hot, but it took me a long time to believe him.
But finally, I realized that my breast cancer robbed my hair, breast and my fertility, but I'm still a woman he fell in love with.
What you look like naked is just a small part of your attraction.
Night sweating means separate blankets
If your breast cancer is sensitive to estrogen, medicines will be given to lower your body's levels. These medications, as well as chemotherapy, cause menopause.
It's worse when you're young and happens overnight. Frequent heat waves and night sweats. When I woke up, I swollen – I thought that I would be wet for the first time. My husband and I have separate blankets and I do not bother him any more when I undo the blankets. But lose the intimacy of sharing the bed.
This menopause can also cause dry and irritation of the vagina and you can completely lose your sex drive.
Estrogen is a natural lubricant, and without it, sex can be unpleasant, painful or impossible.
Start talking … when the time is right
The most important thing that I learned is to be open and honest with my partner. Find a neutral time, somewhere privately, and tell them your fears – you worry that it will be painful that they will not find sexy or your sex drive just disappeared.
Give them time to tell you what their worries are.
They may be afraid to hurt you, or they do not know if they should touch your scar or completely avoid them.
Tell the medical team what's happening
It can be terrible and embarrassing to talk about sexuality or lack of it for your nurse, GP or counselor. But we can do a lot. There are also menopause specialists who specialize in helping women with these symptoms and side effects.
Dr. Louise Newson has an excellent website, menopausedoctor.co.uk, as well as dr. Hannah Short, drhannahshort.co.uk.
Do not be afraid to seek counseling
I had every feeling of guilt after diagnosis. In my opinion, it was my fault if the sex disappeared from the agenda.
I was angry because I lost my sex drive and I resented the fact that I had cancer when my friends were not.
These are feelings that can cause anxiety and depression a whole year later.
Most cancer centers have access to a consultant specifically trained by the Macmillan Cancer Support.
I found this service priceless, especially in conversation with someone who did not think I was crazy and that he had answers to many of my problems.
My counselor helped me figure out how to talk about sex in a way that would not disturb or upset Dermot. This has had a big impact on us.
Do research, and get him to do it
I wrote a perfect breast cancer guide with another doctor and breast cancer patient, Trish Greenhalgh, to share everything we learned.
But I also recommend women who read Me and My Menopausal Vagina, Jane Lewis. Let the partner read you to understand what you are going through.
A charity organization for the treatment of breast cancer has excellent online information about returning to sex. They also have an application called BECCA, with helpful advice from patients and professionals.
I also follow two great Twitter experts, @jodivineuk and @SamTalksSex, who break tabs around sex and offer a lot of tips.
I mention more on my website at liz.oriordan.co.uk.
Discover the joy again with the feelings and dates of the night
After treatment with cancer it can be very difficult to get mood. So return to the basics – try again at the first date and spend some time collecting yourself on the couch like teenagers. Turn off the pressure; it can help you to reconnect.
With Dermot we got used to not having time for ourselves. So we started the weekly room at the cinema. Only we; without mobile phones or interference.
We learned to have fun outside the bedroom again and remember why we fell in love.
If you do so, you will be more inclined to the next step. Just spend that time to feel good about each other.
Practice really makes perfect …
Hormonal treatment drains your sexual urge, so it can take a long time to get up, and although technically it's still possible to experience an orgasm, it's important to explore what is now working for you – initially without the pressure of your partner and then together.
Training the pelvic floor muscles (try to stop the urinary median current) can ease and increase orgasm power. A simple web search will show you what you need to do, or you can ask your doctor.
I advise all patients … to get a bag of tricks
For many years after breast cancer, it does not mean spontaneous sex, especially if you have a vaginal dryness. The lubricant is your savior and I recommend the type "DA", which is ecological without any added chemicals. An additional bonus is that your doctor can prescribe them, so you do not have to pay – cancer patients get free recipes.
Without sex drive, it can take forever to be created. A small vibrator can really help. And dilators can be God's gift, as they can help stretch and relax vaginal muscles.
Find a set that is gradually increasing. I recommend an Inspire Dilator kit made of soft silicone. You can buy them online and send them in discreet packaging.
Are you still fighting? Medicines can help
If you still face dryness despite lubricants, your doctor may prescribe topical estrogen cream or a vaginal tablet such as Vagifem. It was a complete change for me.
And because the amount of estrogen that your body absorbs from these drugs is minimal, it is completely safe to use, even if your type of cancer is sensitive to hormones.
The trial also showed that they will not increase your risk of recurrence of the disease.
Finally, your partner may be struggling to maintain an erection, especially if he is afraid to hurt you. If so, a doctor may prescribe a tablet, such as Viagra.
Surviving breast cancer deserves a pleasant and satisfactory sex life. Talk to your partner. Talk to your doctor. Explore websites about toys for sex. It's about testing and mistakes, but you can get sex life back and have fun.
- The perfect breast cancer guide: How do you feel qualified and take control, Professor Trisha Greenhalgh et al. Liz O 'Riordan, publishes Vermilion at a price of £ 14.99.