Sexual recovery after breast cancer is often overlooked

Sexual wellbeing can often be overlooked during a woman’s recovery from breast cancer with many continuing to experience significant sexual and intimacy challenges long after treatment ends.

Griffith University researchers interviewed 31 breast cancer survivors aged between 32-72 years and developed a three-layer model of post-treatment sexual adjustment.

Lead author, Mina Esmkhani from Griffith’s School of Medicine and Dentistry, said sexual recovery was shaped by embodied disruptions, relational dynamics, and cultural and healthcare influences.

“Embodied disruptions are where a woman can feel pain, vaginal dryness, reduced desire, scarring and altered body image,” Ms Esmkhani said.

“Relational dynamics focuses on partner support, communication, and emotional connection.

“Cultural and healthcare influences look at social expectations, stigma, and whether healthcare professionals discuss sexual health.

“Sexual recovery is not purely a medical issue, but is also physical, emotional, relational and social.”

Importantly though, women with similar treatment experiences could experience different sexual recovery outcomes and may follow one of three trajectories.

Women may feel a sense of disruption including ongoing shame, isolation, and intimacy difficulties.

Breast cancer survivors may experience a gradual adjustment through communication and support, or they may reclaim their sexuality through a renewed sense of self.

Co-author and associate supervisor Dr Charrlotte Seib from Griffith’s School of Nursing and Midwifery said a partner’s response emerged as one of the strongest influences.

“Women who reported empathy, reassurance and emotional support were more likely to adapt positively,” she said.

“This shows that partners are not passive observers and can act either as a buffer against distress or can intensify it through avoidance, silence or discomfort.

“A supportive partner helped women to feel desired, rebuild their confidence, develop new forms of intimacy, and maintain emotional connection.”

Healthcare silence was a consistent response and could contribute towards feelings of shame.

Senior author and project lead, Associate Professor Armin Ariana, said sexual health remained a major gap in breast cancer care.

“Participants consistently reported that clinicians focused on treatment and survival but rarely discussed sexuality, intimacy or sexual side effects,” Associate Professor Ariana said.

“Many women felt they had nowhere to seek advice about painful sex, loss of desire, body image concerns or relationship challenges.

“The findings point to a clear need for change in how clinicians are trained.

“Sexual health needs to be built into standard cancer care conversations, not treated as an optional extra raised only if the patient brings it up first.

“This is exactly what we need to be teaching the next generation of doctors, to ask the question before the patient has to.”

Ms Esmkhani was supervised by senior author and project lead Associate Professor Armin Ariana, an Accredited Clinical Sexologist at Griffith’s School of Medicine and Dentistry, alongside Dr Charrlotte Seib from Griffith’s School of Nursing and Midwifery.

The paper ‘The Explanatory three-layer model of post-treatment sexual adjustment: A qualitative study of breast cancer survivors’ has been published in The Journal of Sex Research.

UN Sustainable Development Goals 3: Good Health and Well-being