Q: I had breast cancer treatment a year ago, and now I’m so happy to be done with treatment and to feel almost like my old self again. Except I have absolutely no interest in sex. I feel really bad about this. My husband has been so fantastic through everything, and he just wants things to be the same as they were before. What can I do? —Libby Sternberg, Ohio

A: First, what you’re experiencing is very common among women with breast cancer. Women aren’t typically counseled about how cancer treatment will change their sex lives. So many women I meet express the same guilt I sense in your letter.

Breast cancer alone can really send you spiraling. You’ve been focused on getting through surgery, chemotherapy and radiation, and all with the goal of simply surviving!

Now, you may be taking medication to prevent recurrence. These drugs block estrogen, and so you may be dealing with the onslaught of menopause and its hot flashes, mood swings and vaginal dryness. Body issues also emerge after treatment—changes in sensation, scars, weight gain and hair loss all over your body including pubic hair can affect how you feel about your body for years. Life after cancer is a new normal, not what life was like before.

While sex is a very physical encounter, it actually begins in your head. Most women go about their days with few thoughts regarding sex until their partner begins touching them or talking to them in a sexual or loving way. Ask your husband to be generous with his solicitations both outside and inside the bedroom. Ask him to initiate sexual activity and to pay attention to those things that seem to excite you.

You have to let him know what gets you interested in sex and be really clear on what’s working for you and what’s not. Do you want him to touch your breast or chest where you had surgery? He may think that touching your surgical area shows acceptance of all that you have been through, but it may be very sensitive and a turn-off for you.

Sex requires effort and energy, and taking time to dwell on sexual thoughts early in the day can help fire up the desire later on. Set the scene with things you find romantic and stimulating, like candles, clothing that makes you feel sexy (a man’s dress shirt can be much sexier and much more comfortable than an underwire bra!), music and lighting that increases your confidence and stimulates your senses.

Don’t think of foreplay as something that must end in intercourse. Treat it as a delicious part of a broad range of sexual pleasure. You don’t eat dessert after every meal—so why should intercourse always follow foreplay?


For the more physical barriers to sex after cancer therapy, such as vaginal dryness, there are plenty of drugstore options. Replens is an over-the-counter vaginal moisturizer that is used to keep the vagina moist. Although it’s not intended for lubrication for sexual activity, it can make you feel more comfortable every day, thereby increasing your interest in sex if you’re not dealing with vaginal dryness and irritation. For sexual activity, try a glycerin-based lubricant like Astroglide; it stays slippery way longer than K-Y jelly.

Your life has changed because of breast cancer, but guess what—your life is changing anyway as you age. So view this as a time to start anew with an exciting and different sex life with your husband.