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Sexuality & Cancer

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:

Fatigue
Nausea
Vomiting
Diarrhea
Constipation
Hair loss
Weight changes
Scars
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.

Featured Podcast:

Sex after cancer treatment: Managing side effects

Clinical psychotherapist Carmella Wygant and advanced practice provider Donna Herrera Bell discuss common culprits and the importance of speaking up about side effects.

View podcast episode page

Read transcript

Sexual dysfunction after cancer treatment: 4 things to know

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.”