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Low Sexual Desire and Breast Cancer

What’s causing your low sexual desire?

Is it the Tamoxifen or is it the cancer that led your doctor to put you on the medication in the first place? How do you sort out what causes desire to vanish? Chronic illness and cancer can create huge life upheavals; stress, physical changes and emotional changes in you, in your work, and in your relationships. You may have lost a breast—a visible reminder in our breast-fixated obsessed society.

If you’ve suffered physical loss along with emotional loss do you still see yourself as sexual? Hormonal changes have an impact on your body. Vaginal dryness irritates tender tissue and can cause pain during intercourse. Other parts of your body may hold physical pain. The treatments can bring on rapid menopause. When you look at all those factors it’s no wonder that sexual desire seems to lessen.

There is a growing body of literature suggesting that sexual dysfunction is a common and distressing problem experienced by many breast cancer survivors. Sexual issues identified in breast cancer survivors include changes in body image associated with the loss of a breast or weight gain, decreased libido, vaginal dryness, and dyspareunia (painful intercourse), difficulty with arousal and orgasm… Journal of Cancer Survivorship


It is not surprising that breast cancer survivors experience changes in their sexual feelings in light of all the other changes they undergo. Unfortunately your doctor may not be very helpful. Leslie R. Schover, a clinical psychologist and professor at the University of Texas M.D. Anderson Cancer Center in Houston, says “doctors rarely ask cancer patients about sexual effects of the disease or intensive treatments such as chemotherapy, which impair sexual functioning of women with many malignancies, including breast cancer, Hodgkin’s disease and leukemia.” (Source)

Cancer specialists can competently discuss chemotherapy, surgery and rehab but they are not trained to talk about sexual side effects. They should be discussing cancer’s impact on sexual desire. Women’s sexual health is crucial at all stages of life—that doesn’t stop in the face of cancer or other chronic illnesses.

The conversations being held on breast cancer sites and in forums aren’t all that helpful in pinpointing a specific cause of low sexual desire. Research cites vaginal dryness as one of the most common side effects of cancer treatments and medication. That dryness can lead to dyspareunia (painful intercourse), which might lead to an avoidance of intercourse. How do you convey to a partner that it hurts to have intercourse? What if intercourse has traditionally been the main sex act for you and your partner? Avoidance starts and the whole experience of having to worry about pain, before it even shows up, is enough to make a woman lose interest in sex and eventually find herself with little sexual desire.

Identifying Causes of Low Sexual Desire

First of all, give yourself permission to feel less interested in sex. Use these questions to clarify your experience of low sexual desire:

  • Where is my pain? Is it real or imagined? Am I anticipating painful intercourse or have I already experienced it?
  • Has losing a breast, having scars, or feeling the effects of a chronic illness changed my perception of myself as sexual woman? Do I still feel attractive?
  • Have I consulted my doctor to talk about side effects of my medications?
  • Are other stresses in my life causing me to feel detached and uninterested in sex?
  • Is my partner rejecting me?
  • Can I talk to my partner openly about these changes and my feelings?
  • Am I willing to explore other avenues to sexual pleasure—ones that don’t include intercourse?

 (Adapted from

 Are you ready to explore the answers to these questions and do the necessary work to regain a sexier state of mind? We know that sexual desire, arousal, starts in the brain. If you’re experiencing low sex desire, identify what’s holding you back and work on the things that you can change. It’s not going to be easy—but if you’re a cancer survivor you already know how to fight. You have the ability to be strong in the face of challenges and take care of yourself.

As I discussed in a recent article don’t think about rushing back to intercourse, start slow and easy. Look at meeting your sexual needs in other ways—sensuous massages, cuddling sessions. Buy a sex toy. Masturbate.  Encourage your partner to pleasure you manually or orally.

You may decide to give up partnered sex temporarily but you still need to pay attention to your vagina (and clitoris). Arousal stimulates blood flow, which helps keep vaginal tissues supple. Take up masturbation, or self-pleasuring as I like to call it, using plenty of lubrication. Practice inserting a small water-proof vibrator or dildo, if penile insertion feels uncomfortable. Try it even when you don’t ‘feel’ sexy—view it as a self-care practice.

There are no expectations.  The goal is to connect with your body in a way that feels soothing, relaxing and eventually pleasurable. Use a lubricant like organic coconut oil or an organic lubricant that is oil or silicone based, unless you’re using silicone sex toys. They feel richer and smoother on the skin than water-based lubes. Be sure to use unscented lubricants made with natural ingredients to avoid irritating delicate tissues. Try products like Sliquid Organic Lube and the Good Clean Love products, to name a few.

There are no easy answers or magic pills to help you regain sexual desire. Give yourself permission to feel what you feel without guilt. Try to answer the questions and take some time to indulge in self-pleasuring rituals. Your goal is to tap into the sexual you—the part of you that no cancer, or other illness, medication, or bad relationship can take away.

If you have more questions, feel free to drop me a note at

(Please note that these are recommendations based on personal practice and research on sexual arousal. I am not a certified sex therapist and have no direct experience working with cancer survivors.)

midlife boulevard, columnist, midlife women, middle-age, midlife crisis

Walker Thornton

We are delighted to have Walker Thornton as our Women’s Sexual Health columnist. After working for over 10 years in the field of sexual violence against women, Walker is now enjoying a new career as a freelance writer, public speaker, and sex educator with an emphasis on midlife women. Her blog, was ranked #5 by in their top 100 Sex Blogging Superheroes of 2014. You can connect with her on Facebook and Twitter For questions about sexual health, write her at

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Karen Sandoval

Tuesday 6th of May 2014

Dearest Walker, I so appreciate the time and research you put in here to answer my questions regarding sex after breast cancer, and how Tamoxifen robs you of your sex drive. I'm now two years off Tamoxifen AND Femara, and zero desire at all has returned in the sex department. I feel so so much better knowing that I am not the only one who feels like this. Low libido doesn't even describe me, it is zero. I am just like the first commenter, I don't even care what is going on down under any longer. I find it disturbing emotionally, because before breast cancer, I was the total opposite. I am OK without sex right now, and my husband is totally understanding. He often reminds me he did not marry me for sex, he married me because he loves me. Again thanks for opening the conversation. I am so glad I am not alone. xo


Tuesday 6th of May 2014

Karen, I'm glad this was helpful-thank you. And, my wish for you is that you regain some of the sexual desire you once had and want to your own time. I'm giving a little shout-out to that supportive husband of yours!

Kim Jorgensen Gane

Monday 5th of May 2014

This felt very compassionately delivered, Walker. Cancer takes so much. It certainly doesn't seem fair that sexual desire, for many, is never the same again, even after the scars heal.

Walker Thornton

Tuesday 6th of May 2014

Kim, thank you. Cancer does take so much, I hope to have given a little support along with useful ideas here.

Claudia Schmidt

Monday 5th of May 2014

As a breast cancer survivor who has had a bilateral mastectomy and is currently on Tamoxifen, I really appreciate this article. It's very thoughtfully written and dead on in terms of the side effects -- thank you. I'm pretty lucky as I don't have any actual physical problems post mastectomy, but I do have a tremendously lower libido than I did prior to the surgeries and before I started the Tamoxifen. Sometimes just having someone else acknowledge what you're going through is very helpful, so thank you for that.

Walker Thornton

Tuesday 6th of May 2014

Claudia, Thank you. I wanted to be sensitive to the subject and not presumptuous about something I have no first hand experience with. And, thank you for sharing your stories with other women.


Monday 5th of May 2014

I am a post menopausal uterine cancer survivor. Doctors removed my uterus, ovaries. cervix and some lymph nodes. Then, about a month later, the stitching holding the top of my vagina together (in place of my cervix) came undone and I began hemorrhaging. I talked to my doctor about fear of intercourse and she gave me estrogen cream.... which I am also afraid of since it can lead to breast cancer. But it goes beyond intercourse. I don't want anything to do with my self down there anymore. Not by myself or with a partner. I'm not really asking for help as much as sharing my story. But I do wonder if I'll ever feel the same again. I have had one orgasm since surgery and it felt different. Muted. Truthfully, not worth the effort.

Walker Thornton

Monday 5th of May 2014

Wow, Carolyn...that's a major life change. I appreciate your willingness to share this with me and with other readers. I would be happy to talk to you, sharing thoughts as well as listening if that's something you ever want to consider.

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