Fatigue, embarrassment, treatment side effects: Cancer can test but also strengthen intimacy.

Fatigue, embarrassment, treatment side effects: Cancer can test but also strengthen intimacy.(IMAGE SOURCE/FOTOLIA)The effects of breast cancer treatment on your body and your psyche can do a number on your sex life, as these seven women can attest.

"It's not that I don't love you"
Johanna, 41, of Chesterfield, Mo., says, "I know there were times when [my husband] was frustrated with the lack of sex, but I tried to explain it to him, probably midway through treatment. We sat down and talked about it and I said, 'I feel really bad for you, but that's at the bottom of my to-do list and it's not that I don't love you.'"

She and her husband did keep the physical part of their relationship alive, though: "He would rub my back and rub my feet and touch me in other ways that would provide the intimacy, but we couldn't go down that path at that time." Several months after her treatment ended, she and her husband "were still dealing with issues; you can't just swing back into it. We talk about it and joke about it. At some point along this path I'll get back to normal."

More about sex and body image

"I had menopausal symptoms"
"When I was diagnosed and treated I was 45 and fertility wasn't an issue, but I was sexually active with my husband," says Angeleno Victoria Tashman, 49, founder of the breast cancer organization Pink-Link, who had chemo followed by tamoxifen. "I had menopausal symptoms from very little estrogen, though my hot flashes have gotten a lot better. The vaginal dryness, low libido, and skin dryness that are attached to estrogen [levels dropping]—I never had a clue about those. Now I take a small amount of estrogen replacement to help with the vaginal dryness."

"I was embarrassed by the way I looked"
"I still have a scar on my breast; [the breast] is shaped differently now because they took a big chunk out of it," says Marguerite Leishman, 53, of Reston, Va., who got engaged shortly after her diagnosis 16 years ago. "I was embarrassed by that; I didn't want to wear a bikini anymore and I felt uncomfortable taking my clothes off in front of my fiancé; I felt misshapen and that I looked weird. I started dressing in baggy clothes.

"Initially I tried to get rid of [my fiancé] because I felt sorry for myself. I said, 'You don't need to be stuck with a woman who has cancer,'" she remembers. "He said, thankfully, 'You're being ridiculous; we're going to get through this together.' So it only actually improved our relationship because I could tell this guy was worth keeping around."

Next Page: "Who's gonna find me attractive?" [ pagebreak ]Toni Saperstein, 47, a registered nurse in Holiday, Fla., didn't realize at first that she was waiting to shower until her husband left in the morning, lest he see her naked. "Initially we had sex in the dark, and that wasn't like us," recalls Saperstein, who also suffered from menopausal symptoms caused by chemo—until she worked with a local compounding pharmacy to create a very low-dose-estrogen vaginal cream.

Victoria LaRosa, 57, of Warrenton, Va., started locking the bathroom door when she took a shower. "One day I forgot to lock the door and I was getting out of the tub" when her husband came in, she recalls. "I went berserk, and he grabbed me and said, 'I love you—you're my wife. I don't miss your breasts! It's all in your head.'"

"Who's gonna find me attractive?"
Dating may bring extra worries. When Pam Tazioli, 54, of Seattle, first heard again from a man she had been seeing briefly before she had cancer, her first thought was, "Who's gonna find me attractive? Who's gonna like me?" she says. "But he was so damn persistent and he knew I had cancer and he still wanted to go out. So I called him."

She remembers in particular their third date, which took place about a week after she finished chemo: "He wanted to know what he could do to help me, so I asked him to bring over some dinner. I wore pajamas, a bandanna over my bald head, and we shared some food and watched a baseball game. It was the best date I have ever had." They've been together since.

Says Sharon O'Donnell, 51, a single mother of two in Hamilton Township, N.J., "It really does change your image; you don't feel very sexual or sensual and you don't even know how you're going to feel to be [dating someone new]. I don't need to worry about that right now because I'm not seeing anyone, but you do think of it and say, how am I going to be? From armpit to armpit I probably have, maybe, a half-inch to an inch between each breast that's not scars. So it's really kind of gruesome."