7.3 Fertility, Body Image & Sexuality

Learning Objectives

Explain how breast cancer can affect fertility, body image and sexuality.


7.3.1 Fertility

Specific breast cancer treatments can affect your fertility (Canadian Cancer Society, 2018b). Fertility is your ability to either get pregnant, bring a pregnancy to term, or get someone else pregnant.

Chemotherapy is one treatment method that can affect your fertility by damaging your ovaries (American Cancer Society, 2022d). Your fertility may be affected immediately or at a later date.

For those who want children, this news can be downright devastating to hear (Canadian Cancer Society, 2018b). Even if you choose not to have children, hearing that you can never have children may still feel weird.

If your fertility is not affected, you can still have complications during pregnancy (American Cancer Society, 2022d). These complications can include:

  • premature birth
  • baby with a low birth weight
  • requiring a cesarean section (c-section). (American Cancer Society, 2022d)

7.3.2 Body Image

Body image is how you feel about your body (University Health Network, 2019). Breast cancer can affect your body image because breasts are associated with womanhood and can provide sexual pleasure. If your breasts are altered or removed during surgery, your self-image may change too.

You might be concerned with how your body looks after breast cancer treatment, or you might worry about what others will think (University Health Network, 2019). Although these are normal feelings, you should talk with a trusted person about them. You can also talk to your healthcare team about whether breast reconstruction or breast prosthesis is appropriate for your situation.

Other ways to improve your body image include focusing on parts of your body that you like and putting more effort into your appearance (e.g., using makeup and getting a manicure) (University Health Network, 2019).

If you would like to learn more about body image issues after breast cancer treatment, check out Video 21 (Sunnybrook Hospital, 2020).

7.3.3 Sexuality & Intimacy

Sexuality and intimacy are parts of everyone’s life (University Health Network, 2019). Sexuality includes sexual behaviour, thoughts, wants, and feelings; meanwhile, intimacy includes hugging, kissing, cuddling, and love. Both are closely linked. As a whole, sexuality and intimacy affect your everyday life and how you perceive yourself.

Breast cancer can change your sexuality and intimacy in many ways (University Health Network, 2019). Fatigue, uncomfortable feelings, stress, pain, and other side effects can hinder your sexuality. Furthermore, some treatments can affect how your body responds to sexuality, such as a lower sex drive, vaginal changes (e.g., dryness), and self-consciousness about your body.

Maintaining Sexuality & Intimacy

Strategies for maintaining your sexuality and intimacy will vary from person to person (University Health Network, 2019). Here are some strategies for dealing with sexuality and intimacy issues:

  • Maintaining open and honest communication with your partner — Communicate your thoughts about your body, emotions, feelings, and desires as they change during your treatment.
  • Planning your intimacy in advance — Set aside time in your schedule for you and your partner to engage in intimacy.
  • Using vaginal lubricants — Manage the vaginal dryness side effect of some cancer treatments.
  • Talking to your healthcare team about your concerns – Ask for recommendations on how to deal with specific challenges you are having. (University Health Network, 2019)

If you need help with sexuality and intimacy issues, you can seek out a sex therapist who can help you navigate these new changes.



Video 21: Sunnybrook Hospital. (2020, May 15). Body image after breast cancer treatment: A resource for patients [Video]. YouTube. https://www.youtube.com/watch?v=tz-31Kg-M7Q

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