Around two million breast cancer survivors live in the United States, according to the National Cancer Institute. It is not uncommon for these women to experience problems of intimacy in their relationship following surgery. For women already in a relationship, the knowledge that one or both breasts need to be surgically removed can be traumatic. At this point, simple survival becomes significant and sex is way down the list of priorities. Treatments are also a problem. Some chemotherapy brings on a premature menopause, with hot flushes, fatigue, genital pain and vaginal dryness.

Over time, and with support, sex is something that can re-establish itself in the relationship. A recent study to come out of Indiana University found that breast cancer survivors are interested in learning more about sexual enhancement products both to help get them in the mood and to deal with some of the physical problems like vaginal dryness.

Debby Herbenick is associate director of the Center for Sexual Health Promotion at IU Bloomington’s School of Health, Physical Education and Recreation. Herbenick was lead researcher of the study which found that, following mastectomy, many women experienced significant problems with sexual desire. The survey of 115 women, found that most expressed an interest in using personal lubricants, massage oils and lotions. Roughly half the sample expressed an interest in using vibrators or dildos. Breast cancer support group meetings and in-home parties were viewed as places where women felt comfortable discussing issues of sexuality and where they could purchase sex aids.

Jayne Garrison has posted some useful tips on the WebMD blog, Love, Intimacy, and Breast Cancer. Following a mastectomy, she suggests, there may need to be some changes made to the positions once enjoyed and the timing and frequency of sex. Lying on the side, for example, may be painful. Garrison suggests that the priority has to be getting well first, but this doesn’t mean that intimacy has to fade away.

Intimacy and sex are different, yet related. Re-establishing some romance is important, even if this doesn’t lead to sex. Intimate lighting, time alone, taking a shower together, or simply taking a walk together are all ways to create an intimate atmosphere.

And what’s the man’s role in all this? Men  can feel out of place, awkward and don’t quite know where to turn. A few stick to their woman like glue and simply seem to slide effortlessly into a support role. Others might need a little help to get a fix on what seems obvious to the woman - but not to them. Shopping, laundry, bills, getting the kids from place to place, are just a few that come to mind. There’s no doubt that a diagnosis of breast cancer can put a huge strain on some relationships, but it can remind other people of what is really valuable.

Maybe you’re thinking this is fine if you’re already in a good relationship, but what if you are single and want to start one up? Well, maybe you have to be the best judge of this. Some women feel it is better to see if a relationship might be going somewhere before they tell a man. This may make it easier for the woman to say, but harder on them if the man decides not to call again. On the other hand, does telling a man you can’t see him on Friday’s because you’re in chemo all day have too dramatic an impact, or is it simply being straightforward? If he’s interested in you as a person, then maybe Friday won’t really matter so much.