I've got breast cancer. Can I still have a satisfying sex life?

Q. I have been diagnosed with breast cancer. Apart from health concerns, I'm worried about how it will affect intimacy with my partner.

A. Any serious illness can lead to changes in sexual desire and arousal. The act of sex may not be as enjoyable.

A diagnosis of breast cancer, the treatment and the side-effects of medications have a direct impact on sexuality. Some people may struggle with body-image issues and fatigue and feel overwhelmed. The side-effects on one's sexuality may linger for a long time after treatment.

If you have been diagnosed with breast cancer, you may have had a lumpectomy (removal of a lump in the breast). This procedure does not necessarily lead to disfigurement.

But a person's feelings about their bodies can be affected by a mastectomy (removal of the breast tissue).

The breasts are an erogenous zone. For some women they form part of their gender identity and losing one or both breasts can cause significant distress and body dysmorphia.

Not many people have the option of breast reconstruction soon after a mastectomy and many live with physical scars on the chest and no option of implants.

The psycho-social and sexual effects of the diagnosis, the side-effects of treatment and the post-surgery experience are not the same for all people with breast cancer.

There are incredible stories of people who have maintained some normalcy while undergoing treatment. It is not predictable how a person will react or what intervention they will require. Some people do not stop being sexually active and continue being intimate.

Women may complete treatment and only then have questions around their attractiveness and being comfortable with nudity. It is important to have access to an inter-disciplinary team of practitioners who will be able to assist.

• Dr Tlaleng Mofokeng (MBChB), sexual and reproductive health practice, DISA Clinic, 011-886-2286, visit safersex.co.za.

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