Breast cancer is one of the most common forms of cancer in the world. While it can affect both men and women, it occurs more frequently in women. It is the third leading cause of death in Iran, causing an average age of death in one’s 40s or 50s, but early detection and treatment can increase the survival rate of breast cancer patients.

Nonetheless, breast cancer and its treatments can impact an individual’s sexual function. A mastectomy (a surgery to remove the breast) may result in feelings of insecurity, sexual self-consciousness, perceived loss of attractiveness and/or femininity, and an overall change in sexual identity. Furthermore, many women experience sexual arousal through nipple stimulation, and may feel a sense of loss in this respect with their removal.

Beyond surgery, other cancer treatments such as radiation, chemotherapy, and hormone therapy can cause premature declines in hormones and result in menopausal symptoms like severe hot flashes, vaginal dryness, fatigue, physical and psychological stress, and other undesirable changes in sexual function. Changes in libido, arousal, and orgasm are not uncommon.

In an effort to determine how mindfulness training might impact the sexual function of breast cancer patients, the authors of a recent study used both quantitative and qualitative approaches to assess a group of 52 women with breast cancer in Bushehr, Iran.

The 52 participants were divided into an intervention group (26) and a control group (26). The intervention group received mindfulness-based stress reduction training in the form of eight 90-minute group mindfulness tutorials, while the control group did not receive any intervention.

Both groups completed the female sexual function index (FSFI) questionnaire before the intervention (pre-test), immediately after the intervention (post-test), and one month after the completion of the study (follow-up). Then, 18 women from the intervention group were interviewed by phone about their thoughts and experiences with the mindfulness-based stress reduction training, particularly as it related to their sexual function.  

Ultimately, 46 of the 52 participants were included in the final analysis. Here is what they found:

• The overall FSFI scores of the intervention group increased (meaning sexual function improved) from the pre-test to the post-test, then declined in the follow-up assessment.
• The control group’s overall FSFI scores decreased significantly from the pre-test to the follow-up stage, after a slight increase at the post-test stage.
• Of the six domains of the FSFI (desire, arousal, lubrication, orgasm, satisfaction, and pain during intercourse), the intervention group’s average desire and arousal scores showed the most improvement throughout the course of the study. All the same, there were no statistically significant differences between the intervention and control group’s scores in these two areas.
• On the other hand, orgasm scores decreased for the intervention group during the study.
• The qualitative analysis revealed that many of the women in the intervention group found the mindfulness-based stress reduction training to be helpful for inspiring “happiness and composure” that in turn led to an increase in sexual desire.

The results of this study support previous research that has shown the value of mindfulness in improving psychological components of sexual function, like sexual desire and arousal.

When a person practices mindfulness, they are able to be more present during a sexual experience and better appreciate its sensory aspects. Additionally, mindfulness training can help limit negative thoughts that may be detrimental to sexual performance, while at the same time spurring more productive, positive ways of thinking.

This shift in thinking can be especially important for people who have endured a cancer diagnosis and treatment. As one participant explained, “Mindfulness is extraordinary; it is as if they replace you with someone else. Positive thinking increased my willingness to return to life.” 

Resources:

• Bagherzadeh, R., Sohrabineghad, R., Gharibi, T., Mehboodi, F., & Vahedparast, H. (2021). Effect of Mindfulness‑Based Stress Reduction Training on Revealing Sexual Function in Iranian Women with Breast Cancer. Sexuality and Disability, 39, 67-83. https://doi.org/10.1007/s11195-020-09660-1.