In the TV series Dying for Sex, actress Michelle Williams plays a woman diagnosed with breast cancer who wants a fulfilling sex life and begins dating. That got me thinking. As a breast cancer surgeon, I’ve had countless conversations about recovery, body image and intimacy. Some patients bravely ask questions about sex and desire, while others hesitate, unsure where to start or afraid to bring it up at all.
Breast cancer diagnosis is a profound life change that affects every aspect of who you are—physically, emotionally, mentally and spiritually. For those seeking to start or continue intimate relationships, sex can feel different. It can bring new challenges—and new forms of connection and joy.
Body Image and Self-Confidence
A cancer diagnosis may change how you see yourself. Surgical scars, hair loss and weight fluctuations can all affect how you feel in your own skin. It’s normal to feel vulnerable or self-conscious. Healing involves not only your body, but also your sense of identity and confidence.
Focus on steps that help you reconnect with your body in a positive way. That might mean buying clothes that make you feel good or using makeup and jewelry to express yourself. Gentle movement, yoga or mindfulness practices can help you feel more connected to your body.
Don’t hesitate to reach out for support—from your partner, friends or a therapist. Talking about how you feel can help you rebuild trust in your body and rediscover pleasure on your own terms. Remember, beauty and sensuality don’t disappear with cancer treatment—they evolve.
Facing Physical Changes
Your desire for sex may fluctuate and feel unpredictable. Physical comfort during sex can change. You may experience vaginal dryness, hot flashes or joint pain from treatment. After surgery, you may notice numbness or changes in breast or nipple sensation.
Don’t simply accept these changes. Here are options that can help:
* Vaginal moisturizers and lubricants can ease dryness and discomfort; ask your doctor for safe options.
* Address libido changes through lifestyle measures, counseling or medical approaches.
* Breast and nipple reinnervation during reconstruction after mastectomy can restore sensation.
* Noninvasive stimulation techniques can improve numbness around scars.
Communication and Partner Support
If you’re in a relationship, intimacy will likely evolve during this time. What once felt pleasurable may not feel the same now—and that’s okay. Honest, open communication about comfort levels, desires and boundaries is essential.
Partners: your patience and compassion matter deeply. Ask questions with care, listen and find new ways to express intimacy—whether that’s through touch, affection or simply presence. Individual or joint counseling can help navigate these transitions.
If You’re Single
You don’t have to put your romantic or sexual life on hold unless you want to. When you’re ready, dating and intimacy can be empowering. Communicate openly about any physical limitations, and make sure to practice safe sex, especially since treatment may increase susceptibility to infections.
Pregnancy, Contraception, and Infections
Some cancer treatments including chemotherapy and radiation can increase the risk of birth defects, so reliable contraception is important. Because treatment may also lower immune function, there’s an increased risk of sexually transmitted infections, yeast infections or urinary tract infections.
Discuss contraception options with your healthcare team to ensure they align with your treatment plan. Barrier methods like condoms are often recommended to prevent both pregnancy and infection.
Listen to Your Body
Above all, listen to your body—and spirit. Healing isn’t linear. Some days you may feel open and energetic; others, you may crave rest and solitude. Be patient with yourself and allow your body to set the pace.
Sex and intimacy after cancer may look different, but can also become deeper, more intentional and emotionally fulfilling. Connection—whether with a partner or yourself—can be a meaningful part of healing and reclaiming your well-being.
Dr. Charusheela Andaz is the associate director of the Breast Surgery Division at Maimonides Health.
