Sarah Cawood, a television presenter, is speaking out about a significant and often overlooked consequence of her breast cancer treatment: the near-complete loss of her libido and the onset of painful intercourse. Nearly five years after her diagnosis with stage one breast cancer in August 2021, Cawood has revealed how the life-saving treatment has profoundly affected her intimate relationship with her husband, Andy.
Cawood underwent a lumpectomy, followed by radiotherapy and is now on a five-year course of aromatase inhibitors, a medication designed to reduce the risk of recurrence by suppressing estrogen production. This medically induced menopause, unlike a natural one, was sudden, plunging her into severe hot flashes and joint pain. However, the most unexpected and distressing side effect emerged a couple of months into the medication: vaginal dryness, or vaginal atrophy, and vaginismus, an involuntary tightening of the pelvic floor muscles that made sex agonizing.
"Simply put, my pelvic floor is so tight that it feels like there’s a wall in the way," Cawood explained. She found that advice to "try relaxing" and "use a good lubricant" was insufficient. The anticipation of pain led to tension during intimacy, causing her husband to stop initiating sex. Combined with her diminished libido, this created a cycle where sexless weeks turned into sexless months.
"Every time Andy and I became intimate, I started tensing up in anticipation of the pain and, because Andy knew he was hurting me, he eventually stopped instigating sex," Cawood stated. "With my lack of libido meaning I never felt like making the first move, it became a vicious circle."
While Andy has been understanding, Cawood experiences guilt over the drastic change in their sex life. She believes men need physicality to feel loved and worries about him straying, though he has assured her this will not happen. The couple has sought to maintain intimacy through other forms of physical touch, such as cuddling and holding hands, to feel like more than just flatmates.
Beyond the physical challenges, the emotional toll of lost desire has been significant for Cawood. She misses the feeling of being turned on, describing it as a loss of a fundamental aspect of her sexuality. Her husband's supportive gestures, like creating a calming bedroom atmosphere with candles and music, have helped her feel cared for, even if not sexually desired.
Last year, the couple participated in 12 weeks of couples therapy, which helped them understand their different