Start with Yourself

Breast cancer treatment can have a profound effect upon human sexuality and sexual expression. The effects will vary from person to person depending upon their: 

  • Age
  • Personality
  • Previous sexual health
  • Severity of illness
  • Social circumstances
  • Culture

Sexuality encompasses a broad area including who we are and what we feel, not just what we do. Meaningful physical intimacy can include hugs, touching, and holding hands as much as sexual intercourse itself. Encouraging communication about sexuality issues and needs is one way that the health care worker can assist their clientele.

Some general effects of illness on human sexuality and sexual expression are:

• Changes in self-image and self-concept.

• Diagnosis: nature and extent of the illness.

• Medication and treatment.

• Illness outcome such as poor prognosis.

• Changes in roles and relationships.

• Increased dependence of one partner.

• Role loss.

• Role changes: changes in ‘provider’ role, nurturing role, or sexual role etc.

• Depression-illness often causes sadness, anger or frustration, with resulting effects on relationships and intimacy.

• Pain may cause decreased libido/desire because of discomfort.

• Stress of coping with disease, lowering the ability to cope with daily life.

• Disease may also have specific effects on sexual functioning. These effects will vary with the type and severity of the disease. They may be direct effects due to physical changes, or indirect effects due to psychological changes or reactions etc.

Be aware of your own needs and express them. Start with loving yourself and then reach out to others. One day at a time.

So as South Africa celebrates its 20 years of democracy, I celebrate my 20th year of survival – just like our country I have personally travelled an incredible journey. Breast cancer taught me so many lessons, but my most valuable lessons come from my patients. Daily I am privileged to share their lives and help them to shine. I am indeed blessed!

Written by Prof Elna McIntosh

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