In October 2017, I felt a small, hard mass sitting above my right breast. At first, I assumed it was a clogged milk duct from breastfeeding my 18-month-old son, Freddie. I tried hot showers and cold packs, but it didn’t go away. While I wasn’t overly concerned, I made a mental note to call my doctor. Just in case.
A few weeks later, on Halloween, I met with my primary care physician to review the results of my mammogram and biopsy. “You have breast cancer,” she informed me. “But the good news is you caught it early and it’s treatable.”
I sat on the exam table in disbelief as she explained my options. After the appointment, I sat in my car and cried. Then I called my husband, Alex. “Just come home,” he said softly. “We’ll figure it out.”
READ MORE: 5 First Steps To Take After An Early-Breast-Cancer Diagnosis
My breast cancer diagnosis ended up being early onset and oestrogen receptor positive (ER+), meaning I wouldn’t need chemotherapy. After many discussions with my oncologist and with women I met through a survivor network, I chose to have a unilateral mastectomy with reconstruction surgery, rather than a lumpectomy with radiation treatment. Less than six weeks after my diagnosis, I said goodbye to the body I’d known – and the breasts that had nursed both my children.
“I said goodbye to the breasts that had nursed both my children.”
My surgery was successful, and after I healed, my oncologist prescribed an adjuvant regimen that consisted of a 10-year targeted hormone therapy to lower my risk for recurrence. He informed me that these breast cancer treatments would push me into early menopause. At the time, the idea of menopause seemed abstract. I didn’t know what it meant or what to expect. I was just happy my cancer was treatable and that I’d be alive to take my kids trick-or-treating the following year.
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Breast Cancer And Menopause
In February 2018, I began my treatment plan. I was prescribed a daily oral medication, letrozole, to kill the oestrogen in my body, and every three months, I went to the cancer centre for a Lupron injection, which shut down my ovaries. Within weeks, I went from being a young, healthy 37-year-old mom to a postmenopausal wreck.
My hair thinned – I’d find a collection of blonde strands in the shower drain at my feet – and I experienced night sweats, mood swings, fatigue, decreased libido, muscle aches and hot flashes.
READ MORE: 11 Symptoms Of Breast Cancer In Women That Aren’t Lumps
After six months, I started to adjust to my new reality. My mastectomy scars were healing, and I found a few supplements that helped with hot flashes and sleep disturbance. I began to believe the worst was over. A huge milestone was getting cleared by my oncologist to start exercising again.
“Running was the only thing that seemed to help my crushing anxiety and bouts of rage brought on by the sudden hormonal shifts.”
Running was the only thing that seemed to help my crushing anxiety and bouts of rage brought on by the sudden hormonal shifts. Lacing up and setting out on the mountainous trails in the Santa Fe National Forest made me feel like I was getting stronger – both physically and emotionally – and on a path toward healing. At times I felt like I was running in circles, but I kept going. I was desperate to get my life “back to normal.”
Still, I knew a huge part of getting “back to normal” – whatever that meant – was being intimate with Alex again. Over months of hospital stays and oncology appointments, where I was routinely poked and prodded by strangers, our sex life had been on hold. It was like I’d gone into survival mode, and I couldn’t access the part of myself that felt desire.
“It was like I’d gone into survival mode, and I couldn’t access the part of myself that felt desire.”
During this time, Alex showed up for me in big and small ways – emptying my surgical drains, setting alarms for my medications, even dancing around in my mastectomy bra to make me laugh. He never once made me feel like I was broken. Instead, he told me there were lots of ways for us to be intimate.
READ MORE: 8 Breast Cancer Myths You NEED To Stop Believing
Alex never rushed me, but I knew he missed me. I missed him too.
The first time we tried to be intimate after I went on the hormone blockers, I was nervous and excited. More than anything, I longed to feel connected to my husband again. But the moment we tried to have intercourse, I felt a sudden sharp pain tear through my pelvis. I shrieked and pushed Alex off me. He landed on the floor next to our bed, arms raised like he’d done something wrong.
“Is it your scar?” he asked.
“No. It’s my vagina?” I said. It came out sounding like a question.
Breast Cancer And Genitourinary Syndrome Of Menopause
It would be nearly one year of trying and failing to be intimate with my husband before I fully understood: The pain I experienced was due to genitourinary syndrome of menopause (GSM). When I finally mustered up the courage to talk to a new oncologist about my vaginal symptoms – dryness, itching and extreme pain during intercourse – she said that up to 84 percent of postmenopausal women experience GSM.
And yet I’d never heard of it or even knew it was a possibility. Few people are talking about the numerous increased health risks caused by early menopause, such as osteoporosis, cardiovascular disorders and dementia, but there’s even less attention given to the significantly life-changing side effects of GSM.
“I had no idea what was happening to my body.”
During menopause, oestrogen levels drastically decrease, affecting everything from sleep cycles to vaginal health. Since I’d gone through it sooner than usual, my levels had plummeted practically overnight. I was was embarrassed and ashamed of my changing body, but my oncologist assured me that nothing was wrong with me.
Instead, she explained the different treatment options for GSM. Given my (ER+) breast cancer diagnosis, I was hesitant to try hormone replacement therapy in the form of a low-dose vaginal oestrogen ring. While my doctor assured me it was safe, she recommended non-hormonal options as the first line of treatment.
READ MORE: “I Conquered Ovarian Cancer And Breast Cancer At The Same Time.”
Over the next few months, I sourced non-hormonal recommendations from doctors, specialists and strangers I met online. I tried a multitude of remedies, from homemade lubes to expensive lasers, and while some of them made me feel like I was doing something, they didn’t fix my pain.
So Alex and I put our sex life on hold again. And while my husband remained patient, it would be a lie to say the lack of intimacy didn’t negatively impact our marriage. We were both frustrated with the sudden shift and subsequent disconnect in our relationship.
“We were both frustrated with the sudden shift and subsequent disconnect in our relationship.”
Eventually, I confided in a friend, who recommended couples counselling. At first, Alex and I were reluctant to go to therapy. But after a while, we both looked forward to our weekly session, where we talked about everything from doing the dishes to date night (or lack thereof). In counselling, we committed to spending time together, just us, once a week, be it a lunch, dinner, or hike. Our therapist also recommended something called a “five-minute exercise,” where we each spent five minutes – without interruption – detailing how we felt and what we needed from the other person. As time passed, we often forgot to do the daily exercise, but whenever we did, we felt closer.
READ MORE: What To Know About Breast Cancer As A Young Woman
Cancer had a severe negative impact on the physical intimacy in my marriage. But in many ways, it also remarkably strengthened our emotional connection. I’d become so obsessed with fixing my body that I’d missed the real issue: I needed to reconnect with myself, to remember who I was after the fear of being terminally ill subsided. And I had to do that before I could reconnect with Alex. I had to remember who he was too – my funny, loving husband – and disentangle him from the role of nursemaid and receptacle of all my feelings.
“Cancer strengthened the emotional connection I have with my husband.”
I have yet to find a non-hormonal remedy for my GSM, but I recently started pelvic floor therapy and hope it will help. If it doesn’t, I plan to try the oestrogen ring. For now, though, Alex and I are focused on building intimacy in other ways. For the first time, we’ve talked openly and honestly about our sexual preferences, and these conversations have strengthened our bond. Going through this together helped us understand how long-term relationships ebb and flow.
Some nights, exhausted from the parenting routine, Alex and I will trade back massages or send each other funny memes while lying side by side in bed. We’ve learned that intimacy can take the form of a shared glance from across the room or a homemade latte with a lopsided foam heart. The truth is, our bodies and our relationships will age, but real intimacy deepens with time.
READ MORE: My Experience With Breast Cancer, At Age 27
In December, Alex and I will celebrate our 10th anniversary. We’re not the same people we were when we stood before our families and recited our wedding vows. But over the years, we’ve lived out those vows. I never could have predicted how the past decade would unfold. Now, I live with the acute awareness that everything can change in an instant. The path to healing still has many twists and turns; it’s a work in progress, like a marriage.
In the aftermath of my breast cancer diagnosis, I’ve come to discern that true intimacy is measured by how we adjust to life’s unpredictable shifts together – how we remain each other’s constant, no matter what else changes.
This article by Anna Sullivan was originally published by Women’s Health US
