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Changes to Sexual Well-Being and Intimacy After Breast Cancer

Ussher, Jane M. PhD; Perz, Janette PhD; Gilbert, Emilee PhD

doi: 10.1097/NCC.0b013e3182395401

Background: Changes to sexual well-being can be one of the most problematic aspects of life after breast cancer, with the impact lasting for many years after treatment, associated with serious physical and emotional adverse effects. However, the primary focus on corporeal changes negates the influence of social and relational constructions of sexuality and illness and the ways in which the meaning of sex is negotiated by individuals and within relationships.

Objective: The aim of this study was to examine changes to sexuality and intimate relationships in individuals who have experienced breast cancer, from a material-discursive-intrapsychic perspective, using mixed-method analysis.

Methods: An online survey containing 47 quantitative and qualitative items was completed by 1965 Australian individuals with breast cancer. Participants were 98% women, with a mean age of 54 years.

Results: Decreases in sexual frequency, response, and satisfaction were attributed to a range of factors, including tiredness and pain, psychological distress and body image, and medically induced menopausal changes such as vaginal dryness, hot flushes, and weight gain. Predominant concerns identified in the qualitative analysis were emotional consequences, physical changes, feeling unattractive or lacking femininity, reconciliation of self to changes, and impact on partner or relationship.

Conclusions: These findings support and extend previous research that reports significant changes in sexual well-being after diagnosis and treatment for breast cancer.

Implications for Practice: The findings are of significance to clinicians because sexual well-being is central to psychological well-being and quality of life, and sexual intimacy has been found to make the experience of cancer more manageable and to assist in the recovery process.

Author Affiliations: Health Services and Outcomes Research Group, School of Medicine, University of Western Sydney, Penrith, Australia.

This study was commissioned and funded by Breast Cancer Network Australia, in the form of a research contract with the University of Western Sydney.

The authors have no conflicts of interest to disclose.

Correspondence: Jane M. Ussher, PhD, Health Services and Outcomes Research Group, School of Medicine, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia (

Accepted for publication September 22, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.