I was diagnosed with an aggressive cancer at 36. Ten years later, I’m still learning to be confident in my body.

• Melissa Eppard is a 46-year-old who was diagnosed with aggressive breast cancer when she was 36.
• The diagnosis, double mastectomy, chemo, and loss of confidence negatively impacted her sex life.
• Ten years later, she has slowly learned ways to feel confident in her body.

This as-told-to essay is based on a conversation with Melissa Eppard, cofounder of Upstate Mary. It has been edited for length and clarity.

In 2014, when I was 36, my 3-year-old son was crawling over me and accidentally kicked me in the chest. It really hurt, and that’s when I discovered a lump on my left breast.

At this point, I was between jobs and didn’t have healthcare. I went through the process of applying for healthcare under the Affordable Health Care Act, but it took six months for me to eventually get my diagnosis of stage one triple negative ductal invasive carcinoma with a hereditary BRCA 1 mutation.

Cancer affected my sex life

I was at my new job when my doctor called to tell me the news. I remember being shocked. I crumpled to the floor and just sat on the carpet crying. All I could think about was the worst-case scenarios. I thought about all the people I knew who had died from breast cancer. Would I see my son grow up? How would my husband raise him on his own?

That initial trauma of learning I had cancer dominated my life. I was so scared and stressed all the time. Sex was definitely not on the table.

When it came time for my double mastectomy, I opted for reconstruction after they removed my breasts and assured me the implants would be safe. Also, at the time, the options offered were only about how I would recreate breast mounds.

I felt a deep grief every time I looked down at my chest after the reconstruction. It was a reminder of this trauma. I didn’t feel sexy at all.

We cuddled and didn’t talk about cancer at night

Immediately after the surgery, I started a round of IVF to freeze my eggs as I was told I would lose my fertility going through chemotherapy. As long as I had a uterus, even if my ovaries were removed, I could carry a baby, or someone could be a surrogate for us.

When chemotherapy started, I lost all my hair and my period. I felt incredibly weak, nauseous, and tired.

Even though I often didn’t want to be intimate with my husband, I knew if you don’t use it, you lose it. I knew how important intimacy, not just sex, was for our relationship. So many couples don’t make it through a cancer diagnosis and treatment.

We started gently, just with a little cuddling. We set a rule about not talking about cancer late into the evening – I needed to shut off that conversation so I wasn’t triggered.

I rarely felt sexy during these months, which had a huge impact on my confidence during sex. While lovemaking didn’t stop during chemotherapy, it was definitely less vigorous and less often. Our sex life was hanging on by a thread.

I had to become intentional about feeling like myself again

Two years after my mastectomy, I decided to get a beautiful tattoo over my implants. I went from feeling disfigured to rare and exotic. There was no one in the world like me. During intimacy, I could look down at myself and not feel horrified or get lost in the trauma all over again.

My breast implants were increasingly giving me pain, so I went back to my original breast surgeon and asked him if he could remove the implants and do an aesthetic flat closure in place of the implants. He turned to my husband to ask how he would feel about it and told me he would only perform the surgery for someone with body dysmorphia.

I dissociated, in shock, that he wouldn’t consider my pain and discomfort. I found another doctor who did the surgery for me. I was surprised at how much freedom and comfort I felt being flat-chested.

For years, my desire and sex life had been like a stalled car. But now, I feel like my engine is revving. I would never compare my sex life pre-cancer to now. It would rob me of the joy of where I am now. I have worked too hard to get here and won’t get stuck grieving what intimacy used to look like.

I’m still here, and my marriage is strong. And I’m so grateful.