Survival is the first concern for women who undergo a mastectomy because of breast cancer; yet women shouldn’t forget their sexual feelings. Breast cancer treatment, surgery, and optional breast reconstruction surgery can be a difficult road, physically and emotionally. Even so, a full mastectomy recovery will hopefully include a full recovery of a healthy sex life, as well.

Because the breast is regarded as a symbol of femininity and attractiveness and is often a source of sexual arousal for the man, a woman who loses one or both breasts often has a strong fear of rejection by her partner. Some women choose to have reconstructive surgery. Although the new breast looks good under clothes, the look and feel of the breast changes, and so that fear of rejection still lingers.

Another factor to consider is that many women go for surgery thinking they may only be having a lumpectomy, the removal of a lump in the breast, and wake up from surgery having lost their entire breast to a mastectomy. In such cases, postoperative counseling is usually vital. A doctor or social worker can usually recommend a counselor to the woman, and many hospitals have support groups.

A counselor who treats a woman who has had a mastectomy must regard the return of sexual functioning as matter-of-fact so the woman receives the message that she won’t be rejected.

The husband or sexual partner should be part of the counseling process, and he should provide plenty of reassurance, especially in the physical form of touching, kissing, and hugging. Because of their fear of rejection, most women won’t initiate sex after a mastectomy, and the partner may also hold back because he’s not sure whether she’s physically ready.

Support groups composed of other women who have undergone mastectomies can be especially helpful to a woman who doesn’t have a partner, but they can also help any woman get through the trauma of losing one or both breasts.

Good communication is necessary after a mastectomy, and a counselor can help establish this. Some counselors believe that the husband should participate in the physical recovery right from the very beginning, assisting in changing the dressing during the hospital stay as a way of letting his wife know that her new appearance is okay with him.

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