Sexual dysfunction after cancer treatment: 4 things to know
July 24, 2026
Sex is a normal, healthy part of adult life. But some side effects of cancer treatment can directly impact your ability to enjoy it.
Advanced practice provider Donna Herrera Bell and clinical psychotherapist Carmella Wygant explored this topic during a recent Cancerwise podcast. Here are four highlights from their conversation.
Men: Don’t confuse infertility with impotence
If you’re a male patient at UT MD Anderson, you will likely be counseled on how cancer treatment could affect your fertility. This applies whether you’re facing an orchiectomy due to testicular cancer, the heavy duty chemotherapy that precedes a stem cell transplant, or some other form of cancer treatment.
The most important thing to remember from these conversations? The ability to sire a child is not the same thing as the ability to maintain an erection.
“Many men equate infertility with sexual dysfunction,” explains Bell. “They think, ‘Oh yeah. I was told I was at high risk for infertility. That’s why I can’t get an erection. But ‘infertility’ doesn’t mean you’re not going to be able to perform sexually. You should still be having erections. You should still be able to ejaculate. If you’re unable to do any of those things, that’s not normal. You need to let your provider know.”
Women: Don’t resign yourself to dryness-related discomfort
Vaginal dryness is an issue for many women, especially those who are already in menopause. But whether it’s caused by low estrogen levels, pelvic radiation, or some other form of cancer treatment, vaginal dryness is not just a problem when it comes to sex.
“Vaginal dryness can be uncomfortable in your daily life, too,” notes Bell. “Many of my female patients tell me, ‘I’m even uncomfortable just sitting at my desk.’ Or, ‘I’m a teacher and I’m uncomfortable standing in front of my classroom.’”
Regardless of what’s causing vaginal dryness, you need not resign yourself to a lifetime of suffering.
“Hormone replacement may help,” notes Bell. “Even women who are not candidates for that could be candidates for topical estrogen — including some of our breast cancer patients. There’s also a myriad of other products that can be used, such as coconut oil.”
Featured Podcast:
Sex after cancer treatment: Managing side effects
Everyone: Don’t overlook medication as a possible libido killer
A change in libido is the most common sexual side effect reported by male and female cancer patients alike.
“It’s not just the sex drive, but the desire and the mental energy around it,” notes Bell. “One of the questions I hear most frequently is, ‘When am I going to get that back?’ Another is, ‘How do I share these changes with my partner? I don’t want them to think it’s their fault.'”
A diminished sex drive can be due to many factors, including self-consciousness about an ostomy, surgery scars or some other change in appearance. But don’t forget that other options may also be to blame.
“As a nurse practitioner, one of the first places I look for culprits is the medication list,” notes Bell. “Many patients are on SSRIs (serotonin inhibitors) or some other drug to treat depression or anxiety. Those can most definitely impact libido.”
Don’t wait for your care team to broach the subject
Wygant and Bell both acknowledge that talking about sexual side effects can be awkward. But sexuality is an important part of adult life. So, don’t be afraid to bring it up.
“Studies show that 70% to 90% of patients want their care team to initiate the conversation,” says Wygant. “But you don’t have to wait. You’re having a natural response to an abnormal situation. It’s OK to talk about it.”
To hear the complete conversation between Bell and Wygant, listen to the podcast.
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