Breast cancer is traumatic and losing your breast due to a mastectomy can take a huge toll on your sexuality and confidence as a woman. Often women have to have one or both breasts cut off, either partially or completely.

A mastectomy is also often carried out on women who are at high risk of developing breast cancer, as a preventative measure. According to the Cancer Association of South Africa (Cansa), breast cancer has been identified as a national priority.

The National Cancer Registry of 2016 lists it in the top 10 with other fatal cancers being cervical, uterine, lung and colorectal cancer. It’s not an old woman’s disease as it can affect women from the age of 15. Cansa reports that risk factors include being overweight, being inactive, consuming too much alcohol, poor dietary habits, smoking and exposure to chemicals.

Crysanne Douglas is a 52-year-old mom of three who was diagnosed with breast cancer in her early 40s. She says apart from the trauma of finding out she had the disease, it took a toll on her mental health and her marriage. She no longer felt sexy or attractive.

“We were a couple who were always sexually active, as in every night. I wasn’t shocked to be diagnosed with cancer because my mom and aunts had it too. I knew it would happen to me eventually. I’m in remission now but had to have my left breast removed. It was the scariest thing for me. And besides the pain after, I was depressed and felt very ugly. I didn’t want my husband near me,” she says.

She explains that apart from feeling incomplete as a woman, she suffered vaginal dryness and had zero desire to have sex.

“My husband was very supportive throughout the process, from being diagnosed to having the operation, taking my meds and having chemo [therapy]. But he also became frustrated after a while when I refused to be intimate, so much that we even spoke of getting a divorce. I felt maybe he needed to be with someone else. But he held on.”

She says they were recommended to go for therapy together and after being fitted with a prosthetic breast she started regaining her confidence.

“It’s important to get help. I don’t think we would’ve survived this if we didn’t. It took me a long time to feel confident again, but his understanding, patience with me and support played a major role in me being intimate with him again.”

According to Breast Cancer Now, these feelings are not uncommon. Many women who are being treated for breast cancer will have decreased sexual desire. Its advice is that even if your sexual activity decreased or stopped, you can maintain a level of closeness with your partner by holding hands, hugging, kissing or finding your own ways of being intimate.

The diagram can help men and women understand the condition.