By Ellen Uzelac, January 2025, AARP
Following a mastectomy, a couple has a tough time figuring out how to get in the mood.
Arousal, as many of you know, can be challenging in our later years. What got us off earlier in life may no longer do the trick.
This week, our experts tackle a question from a couple who are searching for new ways to get each other in the mood following the wife's mastectomy. Even though this couple’s situation is specific, the suggestions from our experts are applicable to many of us.
My wife had a double mastectomy three years ago. We have found arousal to be difficult with her breasts no longer there to help the process. Long, deep kisses are not an option due to a history of Bell's palsy. We are open to any advice.
Where to start — so much to unpack here. If you haven't done so already, certified sex therapist Nan Wise suggests having a candid conversation with your wife about her relationship with her new body.
Help her process how she feels.
Ask your wife: What has been your experience since the mastectomy? "Listening to whatever comes up for her can deepen your emotional connection," Wise says.
People have a hard time leaning into something that might be upsetting or painful, she adds, but to sidestep it interrupts the healing process. "The more we feel the sadness, the loss, the fear, the more we have capacity for pleasure," Wise says.
Acknowledge your own feelings.
Katherine McLaughlin, CEO of Elevatus Training, a sexuality education organization, wonders whether you have mourned the loss. "It marks a redefining of your sexual relationship," she says.
McLaughlin notes that sometimes, when a person's body changes following surgery or an accident, the partner feels he or she can’t touch their partner in quite the same way. McLaughlin says to ask yourself: How are you feeling about touching your wife’s body?
Build a support system.
McLaughlin suggests that you both may benefit from seeing a grief counselor to help you navigate your loss or a sex therapist to help identify new ways to be sexual together.
She also says your wife should consider joining a support group for women who have undergone the same surgery. Other members may have guidance on how to deal with the loss and ideas around arousal as well.
Explore new places on each other's bodies.
Touching each other all over can "resensitize" you to potentially intimate, wonderful, sexual and erotic places on your body that you haven’t explored before, says certified sex therapist Chris F. Fariello.
Find out what’s fun and a turn-on now, he says — the neck, a finger, toes, an earlobe. "Go through things in a systematic process and then start over again," he adds. "This can be really hot and sexy," adding that "We get so stuck on the goals of sex that we forget to focus on the pleasures of sex."
Experiment with types of touch.
Certified sex therapist Laurin Lewis suggests changing up how you touch your wife, experimenting first with a full-body massage.
Lewis says to ask her what she prefers: Does she like a featherlight touch? Would a stronger grasp be more pleasurable? Does she prefer the feel of your fingertips or the palms of your hands?
Her response will show you how "this version of her body likes to be touched,” she adds.
Wise suggests, without touching the genitals, to find places on her body that arouse your wife. "And for you," Wise adds, "experience the subtle sensation you will feel from your own fingers as you touch her."
Make use of the rest of your senses too.
Wise says to map out a "pleasure matrix" that includes all five senses (not just touch): sight, smell, taste and hearing.
For sight.
Wise says to ask yourselves: How do we create an environment that is more of a turn-on? Maybe work with dimming the lights in your bedroom.
Certified sexologist Susan Milstein suggests one way to build arousal: Stare into your partner's eyes, with no physical contact, for about two minutes. "This can be a huge turn-on," Milstein says.
Regarding smell.
Wise says to think about lighting scented candles or enjoying one another’s freshly washed — or dirty — bodies.
To explore hearing.
Wise suggests listening to music you both like. Also, ask if she’d like to engage in sexy talk.
For taste.
As foreplay, Wise says to indulge the sense of taste by sipping wine, savoring chocolates or sampling some of your wife’s favorite flavors. Later, think about covering her genitals, perhaps, and other parts of her body with coconut oil — and licking it off.
"When you go to the matrix, you will discover sensuality across the senses," Wise says. "It's a way to prioritize your pleasure."
Don't rule out the chest.
If your wife has declared the chest off-limits, Milstein says that's OK.
But she adds that some women want to reclaim their chest in its new form: "This is my chest. This is what it looks like now. It may not have same sensation, but it doesn’t mean I’m not a sexual being."
And she says there are areas on and around the chest — like the bottom of the rib cage — that may still have sensation that could result in arousal.
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