Three women have opened up about the devastating impact of breast cancer on their intimate relationships, in the hope it will help other women feel confident to seek help.
Eight in 10 women are unhappy with their sex lives after the disease, according to charity Breast Cancer Care. Of the 800 women surveyed, the majority (94%) said a side effect from breast cancer treatment stopped them having sex – and these struggles can be long-lasting.
Sharon Brooker, 44, was diagnosed with breast cancer in August 2013, a year after getting married and having her third child. She had a lumpectomy as well as chemotherapy and radiotherapy. But two years after her diagnosis, she separated from her husband for nearly 18 months, before getting back together.
"Breast cancer completely changed the dynamic of our relationship to patient and carer," Sharon, who is from Peterborough, explains. "Physical changes like hair loss and scars meant I didn't think I was attractive anymore – I remember looking in the mirror and breaking down in tears as I didn't recognise myself.
"Our sex life ground to a halt and two years after my diagnosis we separated."
She isn't alone in her struggles, Alex King, 31, from Pembury was diagnosed with breast cancer twice in the space of a year and had three surgeries, chemotherapy and radiotherapy. She is currently having hormone therapy.
"My husband has been so supportive during this nightmare, but intimacy between us isn't what it used to be," she says. "The treatment, which grew more intense with each diagnosis, immensely impacted my body confidence. My lovely long hair is gone, my reconstructed breasts feel alien to my body and I just don't feel pretty anymore."
She says there are other, more physical barriers too. Chemotherapy left her with a chronic skin condition which she says makes sex painful, and the hormone therapy has triggered an early menopause, resulting in extreme tiredness.
According to Breast Cancer Care's survey, some of the main side effects of treatment which have stopped women having sex include loss of libido (58%), low self-esteem (47%) and vaginal dryness (45%).
Sharon says when she was diagnosed with the disease nobody told her it could affect her sex life or relationship. She is now back together with her husband, but says it's not easy as she still experiences ongoing side effects like irritation on her breast and vaginal dryness, which can make sex painful. "I find it depressing and hard to talk to my husband about," she adds.
Lack of vital information and support means women are left unprepared for extremely upsetting long-term emotional and physical side effects, says the charity. Chief executive Samia al Qadhi says: "Far too many women have not been told about the impact breast cancer and its treatment can have on their sex lives, leaving them suffering in silence - it is crucial this taboo is broken.
"The NHS must ensure everyone diagnosed with breast cancer has the opportunity to talk about sex, intimacy and altered body image to help get the support they need."
Tricia Hollywood, 56, was diagnosed with breast cancer in 2011 after a routine mammogram aged 49. She went through surgery, chemotherapy and radiotherapy which had a huge impact on her sex life.
As she has the faulty BRCA gene, she wasn't shocked at her diagnosis. However, she was surprised by how hard it was to date after treatment.
Tricia, from Farrow, says treatment severely impacted her confidence: "Weight gain, scars and hair loss meant my body changed a lot. When I started seeing new someone for the first time, it was hard to know when to mention breast cancer. I didn't want his sympathy, but I wanted him to understand why I found it hard to be intimate.
"But I wasn't in a good place, so I ended it quite quickly."
Both Tricia and Sharon agree that after treatment it would've helped to have someone to talk to, who wasn't a family member of friend. "It's hard though because it's so personal - it's hard to find the right person to talk to," Tricia adds.
Sharon agrees. She says she tried various avenues for support including her GP, breast care nurses and a counselling service - but says they seemed to treat sexual issues and intimacy as another side effect to treatment. Instead she needed someone to understand how "emotionally devastating" it was to have lost another part of her individuality and understand the impact it was having on her relationship.
For women going through similar struggles, Alex advises: "Have faith in the fact that your partner or husband still finds you attractive."
"Breast cancer treatment can completely alter your image – weight gain, multiple scars, hair loss and yes, you may not recognise yourself nor feel like yourself and [it's] very easy to push your partner away," she adds. "For me, although I felt like this I made myself trust in the fact that my husband said he still found me attractive - and it helped to keep our relationship close."
Breast Cancer Care provides people with support on sex, intimacy and body confidence after breast cancer. Visit www.breastcancercare.org.uk to find out more or call their nurses free on 0808 800 6000.