Cancer treatment can cause a variety of sexual changes. Even though the causes may be different – surgery, chemotherapy, hormone treatment or radiation – the resulting changes are often similar. Some patients experience changes in all areas (desire, arousal, orgasm, resolution), but others experience none.
The most common sexual change for cancer patients is an overall loss of desire. For men, erection problems are also a common problem. For women, vaginal dryness and pain with sexual activity are frequent. Most men and women are still able to have an orgasm even if cancer treatment interferes with erections or vaginal lubrication, or involves removing some parts of the pelvic organs. It is common for patients to need more time or stimulation to reach orgasm.
You should know that the following common cancer treatment side effects may affect your desire for sex:
- Hair loss
- Weight changes
- Sensitivity to tastes and smells
While medications are available to treat many of these symptoms, some of these same drugs can decrease sexual desire or make it harder to reach orgasm.
It is usually safe to have sex during cancer treatment unless your doctor tells you not to. Talk with your doctor before participating in sexual activities.
Coping with Sexual Changes
When sexual changes do occur, they typically do not improve right away. Finding the most helpful remedy may take time and patience because sexual changes can be caused by both psychological and physical factors.
Treatment-related sexual changes may be long-term or permanent. Talk with your health care team before treatment to learn about what to sexual changes to expect from your cancer or cancer treatment. By knowing what may happen, you may be better prepared and more knowledgeable about possible changes. If problems occur, discuss them with your team and find out how to get help.
If you are having sex during chemotherapy, you may wish to use barrier protection, such as condoms or dental dams (for oral sex), since chemotherapy chemicals can be found in semen or vaginal fluid. Patients in their childbearing years should be aware that a pregnancy during or just after chemotherapy can be complicated by birth defects.
Radiation therapy from an external machine does not make you radioactive or endanger your partner in any way. If you are undergoing brachytherapy, which implants radioactive seeds in your body, you may have to stop sexual activity briefly until the strongest radiation has left the body.
Sex can be a problem if you have bleeding in the genital area following a recent surgery or if your immune system is very weakened.
A cancer diagnosis is a life-changing event that affects many aspects of your life. Often priorities shift, roles and relationships change, and other factors and challenges pop up. With all of these changes and challenges, you may even put your relationship with your significant other on the back burner and neglect emotional and physical intimacy.
But intimacy is no less important for cancer patients. A close connection with your significant other can make it easier to face your diagnosis and endure the new challenges you’re facing – together. Here’s what you should know if you’re intimidated to address intimacy concerns and struggle with whom to turn to for help.
What are common concerns about sexual intimacy during cancer
Many people have concerns about intimacy and sexual functioning during and after cancer treatment. These include:
- Lack of energy. Cancer treatment can make you feel exhausted and sap your energy to participate in both physically and emotionally draining activities, even if you find them enjoyable. This often leaves less time for emotional and physical intimacy.
- Body image concerns. A cancer diagnosis has the potential to change your physical appearance. Weight loss or gain, loss of hair and surgical procedures that alter your appearance can affect how you feel about yourself and can affect your desire to be intimate with your significant other.
- Ability to participate in sexual activity. Frequently, patients experience impotency or have other sexual issues that limit their abilities to participate in sexual activity during chemotherapy, radiation, hormone therapy, or after surgery.
How to adapt and where to get help
- Plan for intimacy. You and your partner may not be used to planning for sexual activity, but setting aside time when the patient is rested can ensure that intimacy remains a priority in your relationship.
- Explore alternate forms of intimacy. There will be times when sexual intercourse is just not feasible, and that’s OK. Cuddling, massage, foreplay, holding hands and simply exploring a shared interest are all ways to be intimate without having sex.
- Communicate with your partner. When intimacy is a concern, the best thing you can do is talk about it. Couples who openly discuss their cancer-related concerns experience less distress than couples who avoid these topics. It’s important to discuss any barriers that could prevent intimacy and modifications to your usual routines that may need to be made. Make any fears or concerns known before it is time for sex. This will help ensure both you and your partner can enjoy the experience.
- Communicate with your medical team. Certain types of cancer treatments are associated with various sexual side effects. Asking your medical team what to expect can reduce anxiety and help you prepare.
Remember, if you have concerns about intimacy and your relationship after a cancer diagnosis, consider talking with your partner, doctor or MD Anderson social work counselor. Our social work counselors can help you talk with your partner and explore ways to help you maintain intimate relationships both during and after cancer treatment.
You can contact
MD Anderson's Social Work team
at 713-792-6195, or tell your nurse or doctor that you would like
speak with a social work counselor.
Sexual problems are one of the most common long-term side effects that cancer patients face. In a survey of MD Anderson cancer patients, almost half of men and women said they had new sexual problems after treatment. Common problems include:
- Erection problems in men
- Vaginal dryness and pain in women
- Loss of sexual desire
Below, Leslie Schover, Ph.D., professor in Behavioral Science and Gynecologic Oncology and Reproductive Medicine, answers common questions about sexual problems affecting cancer patients and how to address them.
Why do cancer patients often experience sexual side
A major cause of these issues is physical damage or changes from cancer treatment. Radiation or surgery in the pelvic area can make sex painful or difficult, and may damage blood vessels or nerves critical for male performance.
In women, chemotherapy may cause premature menopause, and hormone therapies can be linked to discomfort or pain.
Aside from physical causes, a cancer patient’s emotional state can affect sexual desire. These problems can be worse in couples without open sexual communication.
How can sexual problems affect the cancer experience?
Losing the desire for sex or feeling unlovable can add to the grief and anger that cancer patients may feel. While caregivers and partners aren’t physically affected by the treatments, they share the emotional burden of sexual problems.
Couples may stop showing affection and discussing their worries. Fertility concerns also can cause anxiety.
These can all strain relationships, which are important sources of strength for those working to overcome cancer.
What treatment options are available to cancer patients
dealing with sexual problems?
The best therapy for cancer-related sexual problems is a combination of medical treatment and brief counseling.
At MD Anderson, men can seek help from Run Wang, M.D., in Urology’s Sexual Medicine Clinic.
We also have several gynecologists who specialize in helping women with the side effects of their cancer treatments.
Our expert psychologist and sex therapist, Andrea Bradford, Ph.D., who sees women, men and couples, too.
Why don’t more patients and survivors seek out
It can be uncomfortable to talk about sexuality. Many people are afraid to bring it up due to cultural taboos or because they don’t realize how common these problems are.
And though it’s something to talk about with your doctors, these issues often don’t get brought up, unless the cancer patient does so.
What research are you doing to help cancer patients cope with
MD Anderson offers programs to provide counseling for sexual problems, including peer-based and online programs. Internet counseling provides the opportunity for self-help, which can alleviate some of the privacy or embarrassment concerns.
We are currently enrolling men in a study called “hardtimes: Cancer and Men’s Sexual Health.” It is open to men ages 18 and older with any cancer type, and provides access to self-help personal and couples counseling with the option for supplemental phone coaching.
What’s your advice for cancer patients with sexual problems?
Talk to your doctors or nurses about your problems. Sexual health is an important part of your quality of life no matter how old you are. If your team can’t answer your questions, ask for a referral to the Sexual Medicine Clinic or one of the specialists mentioned above.
Also be sure to openly talk to your partner about your problems. The more you involve your partner, the more likely you are to have a good outcome.