This is Part 2 in presenting my paper on Breast Cancer and Women’s Sexuality that I gave recently to the Breast Care Nurses Conference in Melbourne, Australia.
I have suggested that in order to understand how breast cancer affects women’s sexual and romantic lives, we must first understand women’s sexuality in general. When women are diagnosed with breast cancer they have already developed sexual preferences, beliefs and needs, so it’s important to understand about women’s sexuality first and then to look at how breast cancer might change this.
I often describe women’s sexuality as being like a jigsaw puzzle. If you think you can pick up a couple of puzzle pieces and then understand everything there is to know about a particular woman’s sexuality, then you will be in for a rude shock.
Let me give you an example: One of my women clients, who came to me complaining of a lack of interest in sex, said,”I’ll feel like sex if my husband has made the children’s breakfast that morning, the kids aren’t fighting and all the bills have been paid”. Her husband, looking quite puzzled asked, “What has this got to do with sex?” Actually a lot!
Women’s sexuality is complex and in many significant areas different to men’s sexuality. To understand women’s sexuality, we have to know about her social, cultural, and spiritual life, her psychology, biology and even her ethics and her economic circumstance.
For example, if a heterosexual woman can’t afford contraception and wants to avoid becoming pregnant, then she is unlikely to be relaxed and enjoy sex and will probably avoid it if she can. So, suggesting this woman take some medication or hormones to try and ‘fix’ her lack of interest in sex is clearly pointless.
So, what IS women’s sexuality? Here are 8 characteristics that I think help to answer this question.
1. Willingness to get in a sexual mood is very important to sexual arousal and engagement in women.
2. The tug of war between triggers for sexual turn-on (eg, direct touch) and sexual turn-off (eg, negative thoughts) makes getting aroused and having an orgasm hard work for women.
3. Romance, affection and sensuality are necessary for women’s sexual interest and involvement.
4. Women often have difficulty communicating their sexual needs to a partner.
5. Everyday roles and tasks in women’s lives have priority over sex.
6. Women tend towards being sexually conservative.
7. Conflict between being a sexy partner and a devoted mother/homemaker/career woman etc creates guilt about sex (known as the madonna-whore conflict).
8. Sexual attractiveness and body image are closely linked.
While all of these characteristics may not exist for all women, many do, and can contribute to a number of different sexual problems that women experience. Add to this the effects of being diagnosed with breast cancer and it’s not surprising to find that many many women with breast cancer find that their sexual and romantic experiences are affected. I will talk about how the experience of breast cancer creates sexual and romantic difficulties in my next post. Dr V
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