[Sexuality after breast cancer].

Sexual complaints are an often reported complication of breast cancer treatment, however still under diagnosed and rarely subject of oncologic counseling. The etiology is multifactorial: predisposing factors, triggers and maintaining factors can be identified on a somatic, psychological and social-interactional level. Accordingly, the development of the therapeutic approach is based on the identification and, where possible, modification or compensation of those factors which explain and maintain the sexual problems. Most often, loss of appetence is being reported, however, as it may develop secondary to sexual pain (dyspareunia) which is partly due to lack of lubrication as a consequence of therapy induced hormonal changes, the entire sexual interaction as well as sexual experiences since diagnosis and treatment should be systematically assessed. For treatment, vaginal atrophy, climacteric symptoms and, most importantly, the psychological and relational adjustment process to illness induced changes have to be considered.