Thursday, February 11, 2010

Intimacy after Mastectomy

Let's talk about sex. (Dad, don't bother reading any further. K? Thanks.)

It's nearly Valentine's Day, and last night I attended a sex toy party given for high-risk women by the support group Bright Pink at the fabulous women-owned, women-friendly erotica peddler G Boutique (where I treated myself to a super cute Betsey Johnson bra -- in cup size D, hello! -- and a little something else I'm not divulging here), so love and sex and all of that are on my mind. I've read women's accounts of sex after oophorectomy (surgical removal of the ovaries), but I've haven't seen many accounts of sex after mastectomy (Ok, I just googled that and came up with over three hundred thousand hits. So I guess it has been written about. Well, here's another drop to add to the bucket.), so consider what follows a public service.

But in order to discuss sex after mastectomy, I think it's important to review sex before mastectomy. The truth is, the day I learned I carried the BRCA mutation was the day I started to feel differently about my breasts. And that's when I started to distrust my body. I got angry at them, I became scared of them, and I no longer felt much like playing with them, since they themselves weren't playing fair to begin with. But, at least from a sexual standpoint, my breasts were always support players rather than the main act. My breasts have never been particularly erogenous; in fact, I've never quite liked any of the suckling guys are wont to do because, from my angle, at least, it looked like they were nursing, and that did absolutely nothing for me, visually or physically. Nevertheless, I've permitted the sucking and the grabbing and all of the sex acts committed upon and between breasts not for my pleasure but for my partner's. So when I learned my breasts might try to kill me someday, I sort of withdrew them from sexual consideration. Sex during my BRCA year was pretty boobless. Sure, my husband gave them a Benny Hill-esque honk once in a while, but, hopefully, understandably, I didn't much feel like being touched there. (The notable exception to this rule was in the final weeks before surgery. I let my moratorium expire and we did everything we could to them one last time.)

Fast forward to sex life after surgery. I am no longer suspicious of my breasts. But I am by no means comfortable with them. Tomorrow will mark seven weeks since my surgery, and my reconstructed breasts look nearly healed; the jagged incisions are fading under the magic sheen of the scar reduction gel and the bruises are distant memories, as are the drains and gauze and bandages. But I can't help but still think of my breasts as being under reconstruction: my chest in a surgical site, and as such, it can't be disturbed quite yet. I was terrified of developing an infection after surgery and was diligent about care for my incisions, drain sites, and other wounds; and now that I'm healing, I still think of my breasts as a sterile area: no touching without first washing hands and using antiseptic. I've been through so much in the past two months (and indeed, year), it's hard to transition so quickly from breasts-a-site-of-trauma to breasts-as-objects-of-desire.

The other problem, I've found, is that I feel, frankly, fragile. Sure, I understand silicone is strong and my implants are in no danger of rupture from routine married-person sex. But I've been told I can't do things I normally do -- like go running or take a yoga class or do pilates -- because I'm still healing. So reason stands that I shouldn't do anything, including sex, that might compromise my recovery. Which is why, when we've done it, we've left the boobs out of it. Shirt-on sex is not ideal, of course, but it is possible to be intimate given the restrictions. I'm just not sure, personally, how long it will before I'm ready to doff the top and be uninhibited once more.

A very wise BRCA previvor (and certified psychologist) told me that sexuality after mastectomy is a lot like going through a second adolescence. Not only will you have a new body you are uncertain of and uncomfortable with, but both you and your partner will be unsure of what to do, how hard to do it, and when to do it. Imagine groping, fumbling hands unsure of their target or purpose. And what's more, since your new body is at least partially numb, there are no physical cues you can rely on to help guide you in pursuit of pleasure. This advice was frighteningly prescient and eerily accurate. Uncertainty? Check. Fumbling? You bet. Shyness? Yes. But like adolescence, this is a phase I will grow out of. I will become more comfortable with my body and husband will too (I think he already is. He's just waiting permission to get grabby again) and before you know it, we'll be back in sack again. But it doesn't happen overnight. In an oversexualized society, I sometimes feel guilty I wasn't ready to let my porn star tits out to play right away, that I'm taking too long to become fully sexual again. But all of this is uncharted territory, and I'm trying to do what feels right to me. Each of us will recover our sexuality at her own pace, and this is the (frank) truth about mine.

Now, in the spirit of Valentine's Day and the best television drama since the Wire, here is Mad Men's Peggy Olsen with a sexy little come-on:

Happy Valentine's Day! All my readers are my special Valentines!


  1. Thanks for putting it out there, Steph. I blogged about sex after oopherectomy, and felt like it was a public service too. :)~

    Since you are a few steps ahead of me, I really appreciate this post - it makes a lot of sense actually - it'll sort of be like the first time, all over again.. which could actually be kind of nice in a way..

  2. hey steph. ive been following your blog in it's entirety. i love your honesty and candor. i recently started a blog too. Please consider adding me to your blogroll. Hope you don't mind that i added yours to mine.


    hey. ive seen you often on FORCE. although i do not know if there is a BRCA mutation in my family yet i am having a pbm this year. i have started a blog too. please consider adding me to you blogroll.


  3. I can't say enough how much I appreciate you writing this. I'm sure that it is not an easy topic to share with everyone.

    I like that you are honest about the obstacles that are present still. But, you are also hopeful that, down the road, things will become a "new normal".

    I am about 11 weeks out from having my PBM, and as a single woman, intamacy is a huge concern for me. I am not comfortable with my new boobs yet and that may take time. It is reassuring to hear from you that the comfort with sex and with our new selves will come back.

    Thank you for sharing such personal thoughts and feelings!

  4. Steph, thank you for your honesty. Husband who is now back in Afghanistan came home for my surgery and indeed did make me feel very loved afterwards. I'd be a liar if I did not admit in the quiet of the night that I grieve for the lost boob. Meanwhile tissue expander is gradually taking shape and I pray he will be pleased when he returns. What we did before he left we did with my shirt on, was too painful to think of removing it. Only now am I able to remove and apply salve to help with wound repair. Day by day, pain becomes less painful. And his nightly calls reminds me of the depths of our love, and GOD willing, will continue.