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Wednesday, October 10 2018

Are you struggling with intimacy after breast reconstruction?

Navigating sexual intimacy after breast reconstruction

Dr. Ong writes about one of the struggles affecting women after breast cancer in Breast Reconstruction: A patients guide to understanding her treatment options, a supplement to Plastic Surgery News published by the American Society of Plastic Surgeons (ASPS) during breast cancer awareness month.

Are you struggling with intimacy after breast reconstruction? You are not alone!

Many women share intimacy challenges after cancer treatment. A study published in the Journal of Sexual Medicine reported that 70 percent of the 994 cancer-treated patients who were sexually active at the time of diagnosis reported that they were still experiencing sexual difficulties two years after cancer treatment ended. (“Sexual Function After Breast Cancer, “2011) Unfortunately this topic of sexuality and intimacy may be one of the least-discussed side effects of cancer treatment.

A breast cancer patient’s decreased sex drive – a side effect of anti-hormonal treatment -is commonly misinterpreted as, “I am not interested in you” or ” I do not love you anymore. This misconception can cause severe and lost-term emotional pain.  If you are a woman experiencing this, do not blame yourself. This is NOT your fault !

Intimacy challenges

Breast cancer treatment, unfortunately, affects the core of what makes a woman, a woman and can lead to a negative body image as a direct result of surgery and indirect changes, such as weight gain or hair loss.

As a plastic surgeon, I see a huge need for education and support to assist women through their sexuality and intimacy struggles. One of my patients told me that it took time to resume sexual activity with her husband after surgery because he feared he would hurt her. She had to convince hit it was OK to touch  her breast. Her experience is not uncommon.

If you have undergone breast cancer treatment, you may experience a perceived loss of sexuality and unattractiveness in your own mind, perceived loss of sexuality by your partner and side effects of treatment, such as a decrease sex drive, vaginal dryness and painful intercourse. Maintaining intimacy is dfficult when fear and pain are involved.

Remember, intimacy issues are a common result of treatment. Take the following steps to regain normalcy..

  • Get your hormones in balance.

Hormones play a major role in a woman’s emotional and functional needs. Targeted hormone therapy is one of the important aspects of breast cancer treatment. Taking vitamins and supplements to assist with estrogen detoxification pathways and supporting your thyroid and adrenals are extremely important and can help with sleep problems, night sweats and hot flashes. A functional medicine or naturopathic doctor and dietitian can point you in the right direction.

  • Get your weight and energy back

Fatigue and weight gain are common as a direct result of treatment and an overall decrease in physical activity and movement. Slowly transition bak into a healthy lifestyle. This will help you gain more energy, loose the weight and help improve your physical self-confidence.

  • Address some of the side effects of therapy

Estrogen is such a powerful hormone for women, and anti-estrogen therapy such as Tamoxifen can cause significant changes to tissues that rely on it, including bone density and heart health; vaginal dryness and painful intercourse; vaginal looseness and urinary incontinence; hair loss; and brain fog.

Treatment options:-

Topical treatments such as low-dose estrogen cream or DHEA can help improve the health of the tissues. Always have a discussion with your medical oncologist if you are planning to introduce hormones back into your body. I also use non-hormonal topical growth-factor treatments in my practice for patients seeking to avoid the estrogen concern.

Regenerative treatments such as Platelet-Rich-Plasma (PRP) and placental-based products can also make a difference in improving lubrication, tighten tissue (including bladder support) and balancing the healthy bacteria in your vagina.

One final thought, and perhaps the most important, is open communication with you partner.
Together, open communication and these treatment options can help you take the first steps to regaining normalcy, and giving you the confidence to achieve better intimacy.

Cheri A. Ong, MD FACS is an ASPS member and board-certified plastic surgeon practicing in Scottsdale, Arizona.
Her practice is focused on female and functional health. She created the XX Revolution™ as a platform for women to elevate their self-confidence, and giving them the freedom to be the best version of themselves.

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