Relationships, sex & intimacy

Many physical, psychological and practical aspects of living with secondary breast cancer can have a significant impact on personal and sexual relationships.

Here, we explore how these relationships may be affected by a diagnosis of secondary breast cancer and provide guidance, practical tips and sources of support which you may find helpful.

Personal relationships

Some women find that being diagnosed with secondary breast cancer can cause changes to the roles they have in their family and friendship groups. This may affect the relationships you have with those closest to you. It may become clearer who you can rely on for support and who is not there for you during the difficult times. This can cause you to reassess the friendships you have.

Some relationships may become stronger or closer whilst others may ‘fizzle’ or feel less supportive. Some family and friends may struggle to deal with your diagnosis and feel unsure how to communicate this, how to manage their own emotions or how best to support you. Although it can feel very upsetting to lose friendships at such a difficult time of your life, it can help you to focus on and take strength from the fulfilling relationships you do have in your life.

Remember that what might seem like a negative or unsupportive response, such as refusing to talk about your cancer, not getting in touch or making insensitive comments, is likely to be a sign of friends, family and loved ones feeling afraid, confused or even angry with the situation.  

You may also find that, at a time when you feel you need support the most, you end up supporting and comforting them, trying to be positive to protect their feelings. You may even find yourself worried or reluctant to tell family, friends and loved ones about your secondary breast cancer, for fear of upsetting them and disrupting their lives. However, remember that the people closest to you will want to be there for you in whatever way they can. When you feel ready, you may find that it is a relief to gradually begin to share what you are going through with those close to you. This can help them to understand how they can support you, channelling their emotions in a practical way and relieving some of the burden on you.

Your secondary breast cancer may have affected the time and energy you feel able to put into personal relationships. Being open and honest with friends and loved ones can help them to see and to understand this.

You may find it helpful to direct them towards our Support for others section.

Your relationship with your partner

Your relationship with your partner may be particularly affected as you both come to terms with your diagnosis.

Your partner is likely to be going through many of the emotions you are going through. Different people react and respond very differently to the news that the person they love is seriously ill. They are likely to be feeling very concerned and worried for you but also scared and devastated about the prospect of facing life without you. This can be even more difficult if you have children together.

You might find that you have been brought closer together by the diagnosis. On the other hand, you may find that your partner is struggling to come to terms with it and feel as though they are pushing you away.

Top tips to share with your partner

Communicate. Being open and honest with each other is very important and will help you to support one another and to know each other’s needs. Tell your partner if you are worried about being a burden to them or if you are finding it difficult to support them through their emotions. Equally, ask them to let you know when they are struggling or when they need support, time alone or to forget about cancer for a little while. Not communicating these sorts of difficult emotions can add to the strain and worries you are both managing. In being honest with one another, you are more likely to be able to deal with and get past these emotions.

Self-care. Your partner may feel like they want to spend every moment with you and be involved in every aspect of your cancer and treatment. However, this can be exhausting for both of you. Encouraging them to take time for themselves can help them to process what is happening and to ‘recharge’ emotionally and physically.

Get support. In looking after themselves they will feel more able to support you. Direct them towards our Support for others and Signposting sections for guidance on where and how to access support which is right for them.

You may also find it helpful to read our section on ‘coping with other peoples’ emotions’.

Further information

Living Beyond Breast Cancer is an American organisation which provides information and support for women with breast cancer. The ‘Living with metastatic breast cancer’ section of their website has a range of guidance, which has been reviewed by medical professionals, on relationships & communication and how to build a community of supportive relationships around you.

They also provide lots of guidance around managing stress in the different relationships you have, whether friends, loved ones or colleagues.

Sexual relationships & intimacy

Living with secondary breast cancer and going through ongoing treatment can also have a significant impact on sexual relationships and intimacy.

Some people feel as though having a diagnosis of secondary breast cancer must mean sex and intimacy will no longer be a priority or something they consider important. However, a sexual relationship can still be a very important part of your life and many women find that this can bring them comfort and support their well-being.

Psychological considerations

Whether you are in a relationship or single, you may find that your thoughts and feelings towards sex have changed.

Psychologically, you may feel differently about your body or less confident in yourself. This can have a significant impact on sex and intimacy. Some women describe feeling guilty for wanting to enjoy sex and intimacy when they have been diagnosed with secondary breast cancer, since they feel they should simply be grateful to be alive or be more focused on other issues.

However, sex and intimacy can be a very important part of your well-being and there is no shame in looking to fulfil this. It can also be an important aspect of your relationship with a partner and help you to feel closer during what is likely to be a very difficult and testing time for you both.

Communication is key in these matters. Letting your partner know how you are feeling about your body and any emotions or feelings you are experiencing around sex and intimacy can help you both to address these together. It may help your partner to know what you are going through and that they are not being rejected. If you are single, it may be hard to judge when to tell a new partner about your breast cancer or how much to tell them. There is no right or wrong way of approaching this. You may find that, initially, it doesn’t feel like the right time to talk about your diagnosis. As you become more comfortable and get to know a partner more, you may feel more able to discuss it as you begin to share more personal aspects of your lives with one another.

Take time to process your emotions. Give yourself time to accept the changes you might be feeling towards your body, sex and intimacy, rather than allowing these to become a source of worry and anxiety. You may find that, as you start to feel more able to manage and cope with the psychological impact of being diagnosed with secondary breast cancer, you begin to feel more open to intimacy.

Macmillan and Breast Cancer Now have lots of advice on their websites relating to intimate relationships, sexuality & your feelings and sexuality & relationships.  

Physical considerations

Physically, you may be dealing with symptoms and side effects that make having sex difficult or uncomfortable. Vaginal dryness is a common side effect of a range of cancer treatments; if you are experiencing this, you are not alone. Lots of moisturisers and lubricants are available over the counter to help ease this. Your doctor may also refer you to a specialist menopausal clinic where health professionals are able to offer exert advice for women with breast cancer. Please see our Symptom monitoring section for further guidance on managing vaginal dryness.

You might also find that it is painful being in a particular position, for example if your cancer has spread to your bones or if you have pain or soreness as a result of treatment. You may need to be patient with one another and take time to explore what works best and is most comfortable for you.

You may find that you have lost interest in sex, whether as a result of hormonal changes or the emotions and uncertainty you are dealing with. This can be hard for a partner to comprehend without feeling rejected so it is important to be open and honest with one another. You may find that, once you feel more able to manage the physical and psychological symptoms you are experiencing, your sex drive begins to return to what is normal for you. Please see our Symptom monitoring section for further guidance.

Practical considerations

Practically speaking, finding the time for intimacy when you and your partner are managing the physical, emotional and day to day challenges of secondary breast cancer, or finding the time for dating and getting to know someone if you are single, can be extremely difficult. Try not to let this become an added worry or burden and allow yourself to enjoy sex and intimacy if and when the time is right.

There are also a number of practical considerations to bear in mind.

Contraception is an important consideration if you are having sex with a male partner whilst having treatment for secondary breast cancer and have not gone through the menopause (either naturally or as a result of your treatment). Women are usually advised not to get pregnant when having cancer treatment since it can affect a baby’s development. If you are wondering about the possibility of getting pregnant and starting a family following a diagnosis of secondary breast cancer, please see our section on fertility.

Generally, women having treatment for breast cancer are advised to use non-hormonal methods of contraception such as condoms, femidoms or the diaphragm. If you are sexually active, it is a good idea to speak to your doctor, nurse or GP about this and ask their advice as to what would be the best option for you and your situation.

Though it may feel like a very sensitive topic to discuss, your cancer doctor (or, if you have one, your specialist nurse) will be very used to discussing sexual health & well-being and will be able to offer you further advice. Alternatively, you may find it useful to seek advice from other women experiencing this problem via online forums, such as Breast Cancer Now’s ‘Living with secondary breast cancer’ forum or Macmillan’s online secondary breast cancer community.

Getting support

Don’t be afraid to reach out for help. It is very common for people to experience difficulties with sex and intimacy, whether as a result of physical or psychological issues, when living with a cancer diagnosis.

Your GP or practice nurse will be able to offer expert guidance and direct you towards appropriate support or services. This might involve psychological support or counselling. Your cancer doctor (or, if you have one, your specialist nurse) may also know of sexual health services available locally which they can refer you towards.

You can find psychologists and counsellors with expertise in sex and relationship therapy working in your local area by searching The College of Sexual & Relationship Therapists website. Speak to your health professionals to see whether you can access charity of NHS-led service before looking into private options.

Macmillan provide a range of further information of what you can expect from sex and relationship therapy. Though you may feel worried or embarrassed to access this sort of support, it is important to remember that sex is a normal part of most peoples’ lives. These professionals will be experts in helping you to explore and find solutions for the issues you are facing. This is no different to seeking support for any other physical or psychological concern.

Further information

Breast Cancer Now’s Secondary breast cancer information pack has a section on sex & intimacy which you may find useful.

Cancer Research UK also lists a number of organisations who help with issues of sex and sexuality.

Breast Cancer Now’s website also provides some tips for initiating sex and intimacy for women who may have found this difficult at any point since their breast cancer diagnosis.

Page last updated: April 2020