What Sex After Cancer Is Really Like

Molly Kochan, played by Michelle Williams in the new FX show Dying for Sex, is in the middle of another draining session of couples therapy when she gets the call: Her breast cancer is back, and this time it’s spread to her bones. While her well-meaning but clueless husband assures her they’re going to get through it together, Molly starts thinking back to a sexual encounter in her 20s when she got the best head she’s ever had in her life. She runs to the bodega across the street, buys a giant bottle of nuclear-green soda and a pack of menthols, then calls up her best friend and soon-to-be-caregiver Nikki Boyer (Jenny Slate). Kochan tells her about her terminal diagnosis and her horny revelation: “I just kept thinking, I don’t want to die without ever feeling that way again.”

Over the course of eight episodes, Dying for Sex follows Kochan — who made a podcast with Boyer about her experiences in 2020 — as she leaves her husband and explores her sexual desires. Kochan masturbates with internet strangers, uses her cane as a prop when she dabbles in BDSM, and hooks up with her hot neighbor. After a chemo appointment, she gives a golden shower to a grown man in a dog costume (later, when he learns she has cancer, he worries the chemo has rubbed off on him). Kochan’s adventures are one example of how cancer reroutes your sex life, but what does intimacy look like for others?

We spoke with six women — some of whose names have been changed — about their post-cancer sex lives. They talked about struggling with losing their libido and body image after treatment, their dogged efforts to prevent vaginal atrophy — the thinning and drying of vaginal walls due to low estrogen — and the unexpected joys they’ve had along the way, from sex nights fueled by weed gummies to scheduled morning sex and a newfound appreciation for breast implants.

“I was a virgin in treatment and just thought, Okay, I’m going to die a virgin, this might be it.”

I was a sophomore in college when I was diagnosed with Hodgkin’s lymphoma. I still saw a pediatrician, and he found a large tumor sitting on my heart and lungs. I had to drop out of school in Los Angeles and move back home to Washington, D.C., for treatment. I remember my neighbor getting cancer very young and seeing her going in and out of treatment for several years. Weirdly enough, I’d had this feeling I’d be next.

I was treated in a children’s hospital, surrounded by toddlers and kids, the only teenager in the wing. Treatment started with surgery and then a full-time chemo regimen, followed by six weeks of radiation at a hospital. As a teenager, you feel old enough to kiss boys at parties and have a good time. I moved back to my childhood bedroom and regressed. My parents helped me do everything; you need to be taken care of.

People touched me in treatment all the time but in a medical way. I associated touching with discomfort and pain and fear. I was 19, so I never would’ve brought up sex to my doctor. Just the sheer awkwardness of it — that was not a conversation in the room. Even my fertility wasn’t a conversation. I was a virgin in treatment and just thought, Okay, I’m going to die a virgin, this might be it. But coming out of the hospital at 20, with my doctors talking about how I was going to live a long life, I’m like, I’m going to have to figure out all these things that I’m years behind on. My single friends were now in serious relationships or had gone through their first breakups. I thought having boy drama was so cool; I’d only seen it in movies at that point. And I had such a strong desire to have sex, because I wanted to be seen as a beautiful, desirable woman again.

After two years of living at home, I moved in with a roommate in D.C. I started fumbling my way through dating, which is awkward when your life is still so tied to cancer, the least sexy word there is. Immediately after treatment I still felt and looked ill, but I only realized I looked that way because of how people reacted to me. In my mind, I was still the me I was before: outspoken, loud at the party, and comfortable around boys. Now, boys didn’t react to me the same way. I remember having my first kiss with this boy. I went to his apartment on our second or third date, excited to see where the night might go. A St. Jude’s commercial came on the TV and he froze, turned bright red and was like, “Are you okay?” I was like, “Wait, what?” The mood in the room was never going to work. He’s seen these beautiful bald kids onscreen, then he’s picturing me bald. I wanted the night to move forward in a beautiful, sexy, steamy way, but it came to a crashing halt.

He ended up being my first boyfriend, and I had my first time with him. I felt relieved after: He thinks I’m beautiful and sexy, and I feel beautiful and sexy. It marked a moment where I felt reconnected to myself after everything my body had been through. He was a terrible first boyfriend, but that’s part of what I wanted. It was cool to be alive long enough to have that experience.

Dying for Sex really resonated with me; in the past, I’ve seen young people with cancer on the screen in this angelic, romantic way. Our experiences obviously weren’t identical, but as a cancer survivor I felt proud watching Molly. Cancer didn’t deter her desires but fueled them. I’m 15 years in remission as of this month. I have my surgery scars, and there’s a part of my right breast that’s numb. In intimate settings, I tend to steer clear of those areas, but there are things that are maybe always going to come up when you’re naked, right? —Alex Dvorak, New York, 35

“I want to see my man and be like, ‘Oh my God, yes, I want you.’ I want that.”

I was 29 when I found the lump. My doctor was dismissive. She kept saying she didn’t think it was anything, that it was a hormonal cyst. There was racism at play, even though I had family history: My mom was even in treatment for breast cancer at the time. My doctor said, “One person in your family is not a family history, that doesn’t mean anything.” I was like, “Oh, okay.”

Meanwhile the lump got bigger. I tried going to the hospital, but they only do X-rays. Finally I lied and told my doctor my nipple was bleeding, because I knew I had to escalate it. I went to a breast specialist. By that point my tumor was the size of a grapefruit. I was diagnosed with stage 3 breast cancer that had spread to my lymph nodes. After five months of chemotherapy, I had no choice but to get a double mastectomy with reconstruction. My cancer was hormone positive, so I did the monthly shot that depletes your body of estrogen and puts you into menopause. I haven’t had a cycle since June 2021.

Before cancer, I had an active sex life with urges and desires and all that. When I first entered menopause my sex drive was oddly heightened, but then they put me on a pill to completely deplete the estrogen and my drive was gone. The guy I’m dating, I’ve been with since the cancer started — we weren’t even official when I was diagnosed, but he was there through everything. I’m a big believer of use it or lose it; if you don’t remain active on these meds, you’re going to have atrophy and other issues. I didn’t want to experience that, so I was like, Okay, whenever he wants it, I’m going to make sure he gets it, even though I’m not getting horny or anything. Let me make sure I do it, for my sexual health. It’s just like food. If you didn’t get hungry all day but you know okay, I need food for survival, you’re going to put something in your stomach. I know what I have to do.

For me the sensation isn’t different, and luckily, once I’m in it, I’m fine. But now, if I’m not consciously ready, I can easily be like, “No, leave me alone, I have work in the morning.” It does take the spontaneity out of it. We’ve gone from sex a few times a week to once a week.

Sexual health isn’t a priority for cancer patients. Doctors are like, “Just be happy with your life.” After my experience with my first doctor, I don’t trust anybody. My oncology team told me about certain medications to help my sex drive, like antidepressants, but I’m worried that the side effects of medications to give me a sex drive are worse than not having a sex drive. And I’m one of the lucky ones: I can still get aroused and have orgasms. Most people in our community, that’s not the case; with the drive everything else is gone too.

I recently stopped taking the shots in order to come out of menopause. I’m still on one of the drugs that controls my estrogen but a milder version. My period should come in a few months. I’m just hoping when I start back on my cycle that I can have some normalcy again. I want to see my man and be like, “Oh my God, yes, I want you.” I want that. —Alicia, 33, Atlanta, Georgia

“You question yourself : Have I fallen out of love with my husband because he doesn’t turn me on anymore? No, it’s a side effect of chemo.”

I was diagnosed with stage 3 breast cancer at the age of 41. I had an 18-month-old baby and was going in for a routine mammogram. The diagnosis rocked my world. I’d recently lost one of my best friends to breast cancer and took time off my job to care for her. Statistics say you have a survival rate, but she was in her 30s. It kept coming back and ultimately took her life, and I went to a super-dark place.

I had really hard chemo and ended up having a double mastectomy after they found another tumor in the same breast. The surgery took both my nipples, which were big and always had a lot of sensation. Losing them was a big change, but all that mattered to me was that I lived and took care of my daughter. After surgery I found out the treatment hadn’t taken away all of the cancer, so I had to do another 14 rounds of chemo, which was another blow. I went on drugs to block the estrogen from my ovaries, which causes vaginal dryness and joint pain. The monthly hormone-blocking shots I had to take were like postpartum depression on steroids; I couldn’t take ten years of that, so I had my ovaries removed. That was a harder surgery for me than the mastectomy — more pain and infections.

Even before I had my ovaries removed, I didn’t want to have sex. I was truly scared I’d get pregnant again and have to make an impossible decision, so my husband and I just stopped. I was scared and depressed and couldn’t fathom being intimate. I had mouth sores when I started chemo, bone pain and nausea. No one’s in the mood when you feel that way. Before cancer we had a healthy sex life, maybe three or four times a week. I’m fortunate he was supportive. I was so sick, I couldn’t have penetrative sex, so I tried to give him oral. Because I was always nauseous that happened rarely, and if I couldn’t give him oral I’d give him hand jobs. He wasn’t pressuring me, I just thought it was the right thing to do. I even told him to get a massage with a happy ending. He was like, “No way, that’s a trap.”

Doctors don’t talk to you about sexual wellness at all, and I had five oncologists, men and women. Sex was almost a taboo question: Talk to me about having diarrhea or joint pain but not this. I genuinely thought it was just me who had an issue, then I joined a Facebook group called Sex After Breast Cancer. I saw a post from a woman who recommended a sexual-wellness practitioner and flew to Arizona just to see her. She was the first person who sat down with a diagram of a vagina and said, “This is what happens during chemotherapy, this is what happens to the lining during atrophy, this is why you’re dry.” I was like, Oh wow, okay, no wonder all these things feel this way. You question yourself: Have I fallen out of love with my husband because he doesn’t turn me on anymore? No, it’s a side effect of chemo.

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I started taking a hyaluronic-acid suppository that goes into your vagina every three days. You wake up and feel like a teenager. It repairs the lining to the point where I can have sex without feeling like I’m being stabbed by knives. She gave me dilators and exercises and CBD suppositories. After working together for a few months, I’ve reached the point where I don’t have pain with sex, which is huge. I try to have penetration at least once a week to keep the tissues soft and stretched. Still, I don’t orgasm from sex — it doesn’t hurt, but it doesn’t feel good either. Of course I’d never say that to my husband. —Evelyn, 43, Colorado

“My husband and I started having weed-gummy nights once a week. We’ll take showers, set up the room, and devote the whole night to sex. It’s almost a religious experience.”

I was diagnosed with breast cancer a year ago. I have dense breasts and a routine mammogram missed it, but after an ultrasound, a biopsy, MRIs in both breasts, and another traumatic biopsy — you’re strapped down on a table with no place for your face or nose for an hour, a needle jammed into your breast with no drugs — I was finally diagnosed with an aggressive invasive ductal carcinoma. I was around stage 1 or 2, and the initial plan was to have a lumpectomy and do hormone therapy for five years afterward. The lumpectomy turned into a double mastectomy. The reconstruction was so fucking painful; the expanders are like barbed wire under your skin. During the surgery they also found cancer in my lymph nodes.

I was pretty depressed. A part of me thought I was going to die. I’d go on Reddit cancer threads where people talked about how they hadn’t had sex in two years. My husband and I have been married for four years but met ten years ago. Sex has always been a big part of our life together. It’s the best I’ve ever had. He’s five years younger than me and really sexy: thick dark hair, Roman nose, big eyes, a strong lean body and the hairless chest of my dreams. Since we started dating, he would give me tons of foreplay and oral sex and go the extra mile to turn me on, including getting me a Magic Wand for my birthday. What would happen to our sex life?

The longest time we’d gone without sex was around the time of my surgery, but two weeks later, we took a bunch of weed gummies and made a night of it. I’d been in so much pain from the expanders, and a friend of mine suggested these raspberry gummies that she and her mother use — they’re both breast-cancer survivors. My husband and I waited until the gummies kicked in, then we kissed and he gave me lots of head. I was lying on a triangular ramp pillow, and we arranged a bunch of others underneath me to get into a satisfying position. He was gentle and careful not to put any weight on my upper body; I still had expander pain, but arousal minimized it. He did all the work. I just had to hold my vibrator. It was magical.

Then I started chemotherapy, and four months later I felt my vagina changing. I was like, Oh no, this is scary. My gynecologist explained vaginal atrophy to me and said that without estrogen, all women’s genitals shrink up later in life and sex becomes painful. The topic also comes up with older friends. A friend told me about a woman in her late 50s who hadn’t had sex in years, then started dating someone and had really painful intercourse — at that point, you need physical therapy with dilators. That gave me the incentive to keep having sex. My nurse prescribed me vaginal estrogen, which helps, though I still worry about getting cancer again because of the hormones.

With cancer, you hear a lot of stories about men not being able to be the caretaker and leaving. But my husband gives me head as long as I need to get there. I’m obsessed with him. We schedule our gummy nights now. Our friends know it’s code for we’re going to be making a lot of noise in our bedroom. We’ll take showers, set up the room, and devote the whole night to sex. It’s almost a religious experience. It’s fun to have sex while sober but more fun to have this whole sex night once or twice a week.

I still use the estrogen cream as needed, and next month my oncologist is going to measure my hormones. I’ll probably have to get the monthly shots if my estrogen and progesterone is too high. I listened to the first two Dying for Sex podcasts. I really admire Molly. She has a sense of humor, and I love that she tried to follow her bliss when sex called out to her. I’m considering watching the show but worry it will be devastating when she dies. I know I’m going to die, but I really hope it’s not in the next ten years from breast cancer. —Kylie, 47, Oregon

“I’ve been walking around with a uniboob for a year now.”

Before my diagnosis, I enjoyed sex with my husband anytime, anywhere. We made it happen at least three or four times a week. Then came the cancer: while getting treated for gastroparesis, the doctors found cancerous lymph nodes in my abdomen. I went through four rounds of chemo, which weren’t so horrible. I still had desire and was like what do you mean I can’t have sex with my husband? when they advised me to wait 72 hours before having sex. I was in remission from lymphoma when I found a lump in my breast. My cancer was hormone positive, so they removed my IUD and started me on a hormone blocker.

I chose to have a bilateral mastectomy. Even the surgery didn’t curb my desire for intimacy. My surgeon told me not to have sex for a certain amount of time post-op, but I was like, I feel fine, can I take it slow? A month later the incision went necrotic and I had to have a second surgery. Even then, we had sex once a week. Because I couldn’t use my upper body and was stuck in missionary, we got creative with toys and moving my legs around to form the number 4. Pillows are helpful, too. Missionary doesn’t have to be boring.

After surgery, I did three rounds of chemo. I went septic after the first round and ended up with an infection in my right implant, so they had to take it out. I’ve been walking around with a uniboob for a year now. We’re planning more reconstruction, but in the last month or two my husband has been able to touch what’s left of my breasts. It feels good, though it’s taken some time for me to mentally adapt. On one side, I’m flat and shriveled-up. On the other side, I have a decent-looking implant. Part of me thinks, Why even bother? The other part is like, Oh, this is really cool, it’s nice that he’s getting used to me looking deformed. As for sensation, there’s nothing. It’s mostly numb.

Last June, I had a hysterectomy because my uterus kept growing cysts and I wanted to make sure there was no chance of ovarian, uterine, or cervical cancer. The doctors put me on inhibitors that suppressed my body’s hormone production, after which my desire just plummeted. But my husband and I found a compromise. Because I no longer have spontaneous desire, I have him wake me up for morning sex once or twice a week. I’m still able to self-lubricate and don’t have any atrophy that I can feel, but it’s not the same. After 14 years together, I still want him. My brain is like, Hey, I still want to interact with the penis, but the body sensation is gone. I’m concerned I’ll eventually have pain and atrophy, and cancer’s already taken so much from us. —Emma, 43, Florida

“She said, ‘Can I touch your breasts?’ It felt like she honored what had happened to my body.”

Years before I was diagnosed with breast cancer, I was a full-time caregiver for my late partner. We were together for seven years. About a year in she was diagnosed with a rare cancer called pseudomyxoma peritonei, which fills your abdomen and pelvis with a jellylike substance that contains cancer cells. When she was diagnosed, the substance had attached to her ovaries and pulled them to the back of her body. The surgery for her cancer required her to be cut from her sternum to her pubic bone. It took her six months to recover, and we weren’t intimate for a long time. It felt like she was getting better, but then she had stomach issues again, and soon there were no other options — this cancer was a death sentence. She had a second surgery and ended up with a colostomy bag and a cut down her abdomen. It never healed. At that point, I was washing her and feeding her intravenously and making sure that she had all her medication.

As her carer, I felt pure love for her. But I remember us trying to have sex when she had the colostomy bag. She couldn’t get sick or have an infection, so I had to shower before, do all the laundry, and make sure she was clean. We tried to get some nice lighting and candles. We enjoyed tribbing, which involved face-to-face full-body contact, but it didn’t really work. I worried about hurting her or squeezing the bag.

She passed away ten years ago. After she died, I was a grieving widow and didn’t really have sex. Eventually I tried a couple of all-girl play parties, but they didn’t work for me. I moved from England to New York and got to the point where I was like, I’m going to put myself out there. There are lesbians everywhere in New York. I was starting to feel confident. Then, in 2022, I was diagnosed with stage 2 breast cancer. I discovered the lump while cleaning sand off my body at a Fourth of July beach party. I had four rounds of chemo and wanted a lumpectomy, but they found stuff on the other breast and I had to get a double mastectomy, then emergency reconstruction after my expanders ruptured.

As a lesbian, my breasts were very important for me. I’m a curvy girl; I like boobs and I like my boobs, and I really liked my nipples. You lose all of those things, and you don’t want to eat healthy after chemo, so I gained weight and lost my estrogen and muscle mass. I used to be this Jessica Rabbit type, and now I’m sort of this round blob. I lost my great love. I lost my sexual desire. I thought, This is it, it’s not going to happen. I invested in a number of sex toys, got a cat, and thought, This is my life, this is my future.

I wasn’t bothering with dating apps and stopped going out, but one of my friends organizes lesbian-karaoke events, and this January I decided to go to one. This person walked in and my body went boom. I was like, Who is she? I gave her my number and we hung out at the MoMA, doing the classic lesbian thing where it’s like is this a date or isn’t it a date? She texted me every day and every week we did something, but she wasn’t picking up on my signals. One day we went to this social-club event. She was wearing this phenomenal burgundy leather top, just so hot. And I was just like, okay, Tonight I’m going to kiss her. And I did.

We had a drunk fumble — an embarrassing make-out session after too much wine, bumping heads with the lights off — then a little while later we ended up going out to dinner and had sex. I was nervous about showing her my body, but she took her time exploring. She said, “Can I touch your breasts?” I was like, “Sure.” She was stroking and kissing me and trying to work out where I can and can’t feel, because there’s a lot of numbness. It wasn’t worship, but it felt like she honored what had happened to my body. I couldn’t quite orgasm because I’m nervous and on antidepressants, and I worried about not getting wet, but she reassured me that I was. It was so special. As part of my nighttime routine I have to moisturize my breasts to keep the skin feeling good, so after our fun she said, “Can I moisturize your breasts?” It was the nicest thing anyone’s ever said to me. I’d only been touched by doctors who put on hand sanitizer afterward.

I watched the first episode of Dying for Sex and love Michelle Williams, but I doubt I’ll watch more; I wish it had more to say about body image. I’m now perimenopausal and have yet to look at myself naked in a full-length mirror. I’m still shocked by how much weight I’m holding. I wish more shows would depict the full spectrum of cancer experiences, including the difficult, unglamorous parts (losing your nose hair is a surprising and messy experience). It’s important to see bodies and lives like ours on the screen, not just the palatable versions. —Rachael, 45, New York