Cancer may change the way you feel about your body and what feels good to you. But with a combination of self-reflection, physical intervention, communication, and patience, you can rebuild your intimacy.

After a breast cancer diagnosis, the last thing you’re likely thinking about is sex. Instead, you’re probably thinking about your treatment costs, upcoming surgery decisions, the cost of battling cancer, and how to manage the side effects of chemotherapy.

While it can feel embarrassing or even taboo to talk about these issues, I am here to promise you that there’s help available. You’re not alone in these challenges.

Here are five tips for rebuilding intimacy after a breast cancer diagnosis.
Cancer treatment affects everyone differently. Medications and long-term hormone blocking therapy have the biggest impact on sexuality. Most drugs work to shut down ovarian and oestrogen production, which can lead to medical menopause. With medical menopause come side effects such as vaginal dryness, painful intercourse, and a lack of sex drive. Many oncologists aren’t trained on how to identify or treat the sexual side effects of cancer treatment, but there are amazing survivor communities and sexual health advocates ready to help. You have the power to bring up your sexual health and intimacy concerns and ask for support. Yes, it may be awkward, but you don’t have to go through this alone.

Start by raising your concerns with your primary care doctor or oncologist. Ask for a referral to a gynaecological pain or pelvic floor specialist. These specialists address vaginal pain and dryness by recommending the use of dilators, topical lidocaine, lube, and daily moisturising (i.e. liquid vitamin E oil ). Many breast cancer survivors also find pelvic floor therapy to be helpful for addressing pain, which can lead to improved intimacy. For those that need more vaginal pain relief, some oncologists recommend laser treatment.

Move beyond physical healing. Beyond the physical side effects of cancer, your diagnosis and treatment can have a huge impact on your body image. This can then affect your ability to be intimate with your partner or with yourself. Add in the lack of sex drive and the problem can feel insurmountable.So, how do you address the mental side of healing? Working on rebuilding your confidence and adding in habits of self-love are essential. It can also be helpful to work with a therapist to unpack the impact cancer has had on your body image and relationships. Working with an individual therapist as well as a couples therapist has been a great combination to help accelerate the healing process.

Get to know yourself again Your body has changed due to cancer. The physical and hormonal changes can change what feels good to you. What causes arousal and what makes you feel nurtured and safe may be different now. Take some time to get to know yourself again. This can be through self-exploration, hot yoga, long baths, massage, or anything else that helps you reconnect with your body. It’s normal to feel betrayed by your body and angry that cancer stole parts of your intimacy.

Take this shift as a chance to find new avenues of pleasure either alone or with a partner. Try things like sex toys, role playing, or intimate massage that you may not have tried before. If you’ve lost sensation in your nipples due to a mastectomy, acknowledge that grief and then open the door to finding enjoyment in new ways.

Make time to communicate (with yourself or your partner) When we’re hurting, it can be easy to shut off. We avoid being intimate to avoid both physical and emotional pain. But the longer we put it off, the larger the problem can become physically and within our relationship. Try talking to your partner about the challenges you face. Ideally, find a time to talk when there is no pressure or expectation to be intimate. While it may be uncomfortable at first, communication is so important. Your partner should support you with the management of other side effects. This is no different. Starting with facts can be a great way to open the door to new topics. From there, you can slowly get more intimate with the discussion. As you try new interventions and strategies, communication will help you stay connected to your partner. Try to approach the process by learning together. Our partners are healing with us and may not be sure how to help. They may not want to hurt us or may be unsure of how we want to be intimate with the changes to our bodies. Discuss this with your partner and it will bring you together.

Not in a relationship? Take time to have a conversation and reflect with yourself. Having an intimate relationship with yourself is extremely important and one you deserve before you begin an intimate relationship with someone else. You didn’t heal overnight from your breast cancer treatment and rebuilding intimacy won’t happen overnight either. Show yourself grace as you navigate this process.

As you slowly move from reflection, to physical interventions, and then emotional hurdles, remember that you’re making progress just by deciding to make your sexual health and intimacy a priority. Show yourself the same kindness that you would show to your closest friend.

You are not alone If you’re struggling with sex and intimacy after cancer, know you’re not alone. Don’t give up on yourself.