The most common sexual side effect of mastectomy is emotional, not physical. Our culture places an enormous value on breasts as symbols of femininity and attractiveness. It is not surprising, therefore, that when a woman loses one or both of her breasts, she often becomes insecure about whether her partner will be able to accept her and still find her sexually pleasing.
After a mastectomy, women may be very uneasy with their body. Being naked may be very unsettling for both the woman and her partner. It will take time and open communication for both partners to adjust. If it is difficult for you and your partner to talk to each other about sex, or cancer, or both, you may want to speak to a counselor who can help you both communicate more openly. Counselors who can help include psychiatrists, psychologists, social workers, marriage counselors and sex therapists.
Breast stimulation also is a large part of sexual foreplay. After a mastectomy, the area where the breast used to be generally is much less sensitive. Although some women still may enjoy being caressed in the area of the healed scar, other women may not.
A few women may experience chronic pain in the chest and shoulder area after a radical mastectomy. If you have chronic pain in these regions, you may find that supporting your body with pillows during intercourse helps alleviate the discomfort.
Women who have had breast reconstructive surgery after a mastectomy also may experience a loss of sensitivity in the breast and nipple area. The nerves that supply sensation to the nipple run very deep into the breast tissues. These nerves often are severed or damaged during the mastectomy. Although reconstructive surgery can restore the breast shape, reconstructive surgery cannot restore normal breast stimulation. Also, unfortunately, a rebuilt nipple has much less feeling. The good news is that, in time, the skin on the reconstructed breast will regain some sensitivity.
The greatest benefit of breast reconstruction is the emotional boost that it gives to women. Although a reconstructed breast may not be able to feel the same level of pleasure as before the mastectomy, the reconstructive surgery can help a woman regain a sense of psychological comfort with her body and bolster her feeling of attractiveness.