Sex may not be quite the same for a while, depending on your treatments and the way you feel about your body.

Sex may not be quite the same for a while, depending on your treatments and the way you feel about your body.CorbisYou might be one of the lucky few whose sex life cruises through breast cancer diagnosis and treatment without so much as a bounce. More likely, there are bumps in the road or you may have stalled out altogether. According to the National Cancer Institute, one in two women treated for breast or gynecologic cancer experiences some combination of low desire and pain with intercourse. Below, a list of the most common problems and some expert suggestions on what to do about it.

1. Fatigue

Breast cancer typically brings on one of the biggest libido-killers: fatigue. Recovering from a mastectomy—and perhaps reconstruction—can sap your energy, as can chemotherapy and radiation. "Fatigue is a bigger problem because it can be pervasive and it can last a lot longer" than other physical changes such as hair loss or dry skin, says Helen L. Coons, PhD, president and clinical director of Women's Mental Health Associates in Philadelphia.

2. Vaginal dryness

If you're on hormone treatment, you may be plunged into early menopause, and for some people that includes low desire and vaginal dryness, which can make sex painful. (Younger women and women who've had chemotherapy are generally more likely to report problems with sex.) Leslie R. Schover, PhD, professor of behavioral science at the University of Texas M. D. Anderson Cancer Center in Houston, suggests a vaginal lubricant and/or a vaginal dilator to make sex less painful. "Being on an antidepressant or anti-anxiety medication can also blunt sexual desire," she says.

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