Gender, Culture and Health Research: PsyHealth, School of Psychology, University of Western Sydney, Penrith South DC, New South Wales, Australia.
Maturitas. 2010 Aug;66(4):397-407. doi: 10.1016/j.maturitas.2010.03.027. Epub 2010 May 2.
It is widely recognised that women's sexuality can be particularly complex after breast cancer, with sexual changes often becoming the most problematic aspect of a woman's life. The impact of such changes can last for many years after successful treatment, and can be associated with serious physical and emotional side-effects. The objective of this paper is to review research on breast cancer and sexuality from the years 1998 to 2010. Research has documented a range of physical changes to a woman's sexuality following breast cancer, including disturbances to sexual functioning, as well as disruptions to sexual arousal, lubrication, orgasm, sexual desire, and sexual pleasure, resulting from chemotherapy, chemically induced menopause, tamoxifen, and breast cancer surgery. Women's intrapsychic experience of changes to sexuality includes a fear of loss of fertility, negative body image, feelings of sexual unattractiveness, loss of femininity, depression and anxiety, as well as alterations to a sense of sexual self. The discursive construction of femininity and sexuality shapes the way women construct and experience their illness and their body - leading many women to try to appear 'normal' to others post-breast surgery. Finally, the quality of a woman's partnered relationship consistently predicts sexual health post-breast cancer - reinforcing the importance of recognising the intersubjective nature of issues surrounding breast cancer and sexuality. It is concluded that analyses of sexuality in the context of breast cancer cannot conceptualise the physical body separately from women's intrapsychic negotiation, her social and relational context, and the discursive constructions of sexuality and femininity: a material-discursive-intrapsychic interaction.
人们普遍认识到，女性的性健康在乳腺癌后可能变得特别复杂，性变化往往成为女性生活中最成问题的方面。这种变化的影响可能会在成功治疗后持续多年，并可能与严重的身体和情绪副作用有关。本文的目的是回顾 1998 年至 2010 年期间乳腺癌与性健康相关的研究。研究记录了女性在乳腺癌后性健康方面的一系列身体变化，包括化疗、化学诱导绝经、他莫昔芬和乳腺癌手术导致的性功能障碍，以及性唤起、润滑、性高潮、性欲望和性快感的紊乱。女性对性健康变化的内心体验包括对失去生育能力的恐惧、负面的身体形象、性吸引力下降、失去女性气质、抑郁和焦虑，以及对性自我的改变。女性气质和性的话语建构塑造了女性构建和体验疾病和身体的方式——导致许多女性在乳腺癌手术后试图向他人表现得“正常”。最后，女性伴侣关系的质量始终预测乳腺癌后的性健康——这强化了认识到乳腺癌和性健康问题的主体间性质的重要性。总之，在乳腺癌背景下对性健康的分析不能将身体与女性的内心协商、她的社会和关系背景以及性和女性气质的话语建构分开：这是一种物质话语内心互动。
