How to face the sex life of couples after breast cancer surgery?

  Sexuality is an unavoidable and very important issue in the recovery process of breast cancer patients. Especially for the younger breast cancer patients, to normalize their life and to obtain the ideal physiological, psychological and social functions, it is necessary to correctly understand and treat the sexual issues.  In clinical work, we often encounter these doubts and questions, such as “will married life lead to recurrence of breast cancer”, “is sex harmful to patients’ body”, “will tumor be transmitted through sex”, etc. “These concerns and worries are superfluous. These concerns and worries are superfluous, especially the claim that the so-called sex life will promote cancer recurrence and metastasis is wrong.  On the contrary, moderate, harmonious and regular sex life is not only harmless to the body, but also can enhance patients’ self-confidence, help maintain the balance of patients’ endocrine function, improve the immune function of the body, and also harmonize the relationship between husband and wife, enhance patients’ confidence to overcome the disease, which is conducive to patients’ recovery and even effectively prevent breast cancer recurrence. Because tumor disease is not an infectious disease, it will not be transmitted to each other through sexual life. The recovery of sexual ability also reflects the recovery of the whole organism from the other side.  The most common sexual dysfunction after most breast cancer surgery is low or no sexual desire. The most important thing is that it is not just a matter of the psychological and physical aspects, but also a matter of the psychological disorder.  Sexual dysfunction occurs suddenly, usually after the diagnosis of cancer or after treatment, and is mostly caused by somatic disorders or physical changes.  The main reasons for this change in sexual function are: organic functional changes due to mastectomy and changes in self-image. After mastectomy, breast cancer patients often have concerns and worries about their physical beauty and even think that they are no longer “fully” female and worry whether their husbands still love them. Patients often feel a sense of loss and inferiority, and their hearts are full of contradictions and sorrow. They lose confidence in sexual expression and become passive in sexual life, which may develop into sexual indifference and affect the harmony of sexual life in the long run.  Due to the lack of understanding or misconceptions of patients and their spouses about breast cancer, such as the stimulation of sexual life will cause cancer recurrence and metastasis and the fear that cancer may be aggravated by sexual life, there is an unbalanced mentality between husband and wife.  The side effects of treatment can cause psychological and mental stress, fatigue and physical incompetence in patients. In Ganz’s survey report of 227 cases of early breast cancer 1-3 years after surgery, 54% of the patients had decreased sexual attraction, 44% were not interested in sex, and 58% had decreased frequency of sex. In our national survey, 58% of the patients stopped having sex completely, while our questionnaire survey of 198 patients one to one and a half years after surgery showed that 79% of them had never had sex after surgery. In addition, the younger the patient, the higher the level of knowledge, the more important the change of shape, the higher the rate of sexual dysfunction, probably because the patient is young, highly educated and has a higher sense of self-worth, pay attention to physical beauty, and when the image is damaged, it will cause psychological imbalance, resulting in serious psychological reactions of postoperative patients, more sensitive to the husband’s reaction, mostly professional women, white-collar class, pay more attention to their own image.  When is the most appropriate time to resume sexual life?  How to grasp the right amount of sexual life? It is difficult to have a unified standard answer, depending on the degree of recovery of the patient’s condition, depending on the person. During the treatment period and in a weakened state of the patient is not suitable for sex. Generally speaking, it is appropriate to have sex without feeling reluctant and not feeling tired the next day. As for the frequency of sexual life, sometimes it is related to the frequency of sexual life before the disease and the patient’s physical condition, age, type of disease and the degree of recovery. Even if the recovery is better, it should be appropriately lower than the frequency of sexual life before the disease, so as not to overexert physical strength, affecting physical recovery. Premature resumption of sexual life or uncontrolled indulgence is not conducive to the recovery of the disease and will lead to the increase of the weakness of the organism. Therefore, breast cancer patients are fully capable of having the same sexual life as normal people. It is the right attitude not to overindulge and not to force restraint, but to let nature take its course. Moderate sexual life can prevent the recurrence of breast cancer after surgery.  The most important thing is that the patient should overcome the inferiority complex and think that you are respected and loved by your lover not only because of your appearance but also because of your inner character and other valuable features. If the couple respected and loved each other before the disease, the sex life was pleasant and satisfying, and the disease will be restored as before.  Provide necessary counseling and guidance to the patient, and build up confidence to resume sexual life by providing the patient with certain real information and information about the impact of cancer treatment on sexual life, especially to dispel the misconception that the stimulation of sexual life will cause cancer recurrence and metastasis and worry about aggravating cancer.  Encourage patients to wear prosthetic breast to minimize the psychological barriers to sexual function caused by the change of body shape, thus eliminating the patient’s inferiority complex and improving the quality of life. Encourage patients and their spouses to communicate with each other on related issues, to gain mutual understanding, and to gradually resume sexual life, choosing the appropriate time and place. Men should make good use of instrumental contraception beforehand. When resuming sexual life after surgery, if the surgical incision or wound is still tender, minimize the squeezing of the chest to avoid distraction due to painful discomfort. If you feel that your conjugal life is not going well, you can also change the repressed psychology of breast cancer patients by adjusting the bedroom environment and diverting your attention.