— How Can Breast Cancer Affect Sexual Health

By Serenity Mirabito RN, OCN

Physical changes in your body due to breast cancer treatment paired with feelings of loss and fear can reduce libido (sex drive) and ultimately lead to depression.

It’s important to have open communication with your healthcare provider if you’re experiencing sexual problems after a breast cancer diagnosis.

This article will discuss how breast cancer affects sexual health and ways to prevent or treat sexual problems associated with breast cancer

Connection Between Sexual Problems and Breast Cancer

Although chemotherapy, hormone therapy, surgery, and radiation are needed to treat, cure, or prevent breast cancer, they can also cause sexual dysfunction. Due to hormone fluctuations, medication side effects, and poor body image, sexual health is greatly affected by breast cancer. Intercourse is not usually dangerous; however, sex can be painful for women, and men may experience erectile dysfunction.

Does Breast Cancer Treatment Cause Sexual Problems

The following are ways breast cancer treatment can cause sexual dysfunction in men and women:12

Chemotherapy: Certain chemotherapy agents (anthracyclines and taxanes) have toxicities that reduce sexual arousal and desire. These medications cause fatigue, nausea, and diarrhea, all of which can lead to decreased interest in sex and intimacy.
Hormone therapy: Hormone receptor-positive breast cancers are often treated with aromatase inhibitors and selective estrogen receptor modulators, which cause hot flashes, vaginal dryness, insomnia, and painful intercourse in women. Men on hormone therapy for breast cancer can experience low libido and erectile dysfunction.
Surgery: Breast surgeries (mastectomy, which is removal of the breast, and lumpectomy, which is removal of the cancerous tumor) and sentinel lymph node dissection (lymph node removal) result in emotional and physical distress. Pain, numbness, and swelling of the surgical site can cause discomfort, while the scars from surgery can lead to poor body image.
Radiation: Radiation therapy can result in persistent pain, lymphedema (swelling), reduced flexibility, and pain in the affected breast, arm, and axilla (armpit). Studies show these side effects correspond with poor quality of life, including sexuality.

How Are Sexual Problems With Breast Cancer Treatment Alleviated?

Following your treatment regimen is essential to surviving and thriving with breast cancer. These tips may help prevent or alleviate sexual problems from breast cancer treatment in men and women:3

Be open and honestly communicate your feelings with your partner.
Try sex in different positions until you find one that’s comfortable.
Intimacy isn’t just about sex. Kissing, snuggling, and touching can also provide intimacy.
Use lubrication to help make sex more comfortable.
Some antidepressants are used to improve sexual desire.
Sexual rehabilitation/therapy can help assess and treat sexual dysfunction in people with breast cancer.

Studies show that healthcare providers don’t always provide sex education to patients with newly diagnosed cancer. Be sure to discuss this topic with your oncology team before treatment starts so you know what to expect.4<

Symptoms and Gender Differences

While breast cancer is the most common cancer in women (after skin cancers), male breast cancer is rare. However, both genders experience symptoms of sexual dysfunction with breast cancer.

Men

Because male breast cancer makes up less than 1% of the total breast cancer cases yearly, information about breast cancer in men is significantly lacking. One study found education about sexuality was the most frequent unmet information need reported by male breast cancer survivors.5

Common sexual problems men with breast cancer may experience include:

Loss of libido
Erectile dysfunction
Poor body image
Feeling emasculated
Infertility

You will likely need to ask your healthcare provider how your treatment will affect your sexuality, as little information is shared with men on this topic.

Women

Symptoms of sexual problems in women with breast cancer include:

Loss of libido
Hot flashes
Vaginal dryness
Painful intercourse
Poor body image
Infertility

Although there is a great deal of information about how breast cancer affects the sexual health of women, you will likely need to ask for education on this topic as well.

How Are Sexual Problems With Breast Cancer Treated?

The first step in treating sexual problems with breast cancer is to speak to your healthcare provider. Whether male or female, sharing your new or worsening sexual side effects with your oncology team is vital. Additionally, being referred to a sex therapist or for sexual rehabilitation can help assess and diagnose the dysfunction and formulate a treatment plan that fits your individual needs.

It may also help to do the following:

Premenopausal women with breast cancer may improve libido by using Addyi (flibanserin), a prescription medication that increases sexual desire.
All women with breast cancer should use lubrication to prevent painful intercourse. Ask your healthcare provider about topical lidocaine if lubrication doesn’t improve comfort during sex.6
Men with breast cancer experiencing sexual problems may find relief from oral medications that help get and keep an erection. Other medical options include penile injections, urethral pellets, vacuum erection devices, and penile implants.6

For both men and women, the following may help improve sexual problems associated with breast cancer:

Psychological counseling
Cognitive behavioral therapy (CBT)
Joining a support group
Hypnosis
Acupuncture
Exercise
Reducing or eliminating alcohol
Getting enough sleep
Eating a healthy diet
Egg and sperm donation before starting cancer treatment

Check with your healthcare provider before implementing any new treatments for sexual dysfunction.

Summary

Whether you’re male or female, you will likely experience sexual problems if you have breast cancer. The consequences of cancer treatments such as chemotherapy, hormone therapy, surgery, and radiation can cause sexual dysfunction leading to depression. Speaking to your healthcare provider about how breast cancer will affect sexuality is important as there are ways to prevent or alleviate these side effects.

A Word From Verywell

Changes in appearance from breast cancer surgery can greatly influence body image and self-esteem in both men and women. Weight gain or loss, hair loss, breast removal, and scars can make you feel self-conscious. It’s important that you don’t feel rushed into sex until you’re ready. Enjoying other ways to feel close to your partner is equally as satisfying. Be sure to seek help from your healthcare provider if new or worsening sexual problems occur.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.