Updated February 12, 2011
Returning to an active sex life after a mastectomy and breast reconstruction surgery is both a physical and emotional issue. Pain from the reconstruction may prevent the patient from engaging in sexual activity, as the chest will be both sore and tender with many movements. As the soreness fades the decision to return to sexual activity may cause anxiety and stress.
Sex may be physically possible but the issue can be emotionally charged. Concern about the appearance of the newly reconstructed breast or breasts is natural and to be expected. Patients are often concerned about the surgical scars and the sensation in the breast, which is often different than it was prior.
An open discussion between the patient and her partner may help to clear the air and alleviate concerns either partner may have. The patient may be concerned about appearance and sensation while the partner may have concerns about hurting the breast or inflicting pain on a tender area.
Including a conversation about the way the breasts feel, how sensation differs from sensation prior to the surgery and what sensations are pleasurable may prove helpful when resuming sexual activity.
It is also important to remember that sex may not feel like a priority when dealing with a life-threatening illness, and a lack of sex drive may be part of the illness as a whole, rather than concern over the breast. A lack of desire may have more to do with cancer treatments and the side effects and less to do with the appearance of the breast.
Depression is common in patients with breast cancer, almost half of all people diagnosed experience depression in the year following diagnosis. Depression can severely diminish sex drive as the symptoms, including the fatigue and irritability, can make sex unappealing.
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