Sex & Cancer
For many, sexual function is an important aspect of one’s quality of life. Cancer can often impact sexual function and relationships, and you may need information and support. You can talk with your healthcare team openly about concerns you have. You are not alone.
What changes in sexual function are expected?
Many cancer survivors will experience changes in their sexual health. This may include concerns about appearance, a loss of desire for sex, difficulty with arousal and orgasm, and vaginal dryness and/or pain.
Surgery for breast cancer may causes changes in body image and/or arousal patterns. Surgery for pelvic cancers can lead to symptoms associated with menopause like vaginal dryness, pain with sex, and changes in arousal. Chemotherapy can also cause permanent or temporary menopausal symptoms. Radiation to the pelvis (particularly a type called “brachytherapy”) can cause temporary or permanent fibrosis of the vagina, causing pain and/or difficulty with penetration.
For males, physical side effects are more likely with treatments that affect sex organs directly (prostate, bladder and testicular cancers). Sexual side effects in males can include less interest in sex, erectile dysfunction, premature ejaculation, passing urine during orgasm, dry orgasm (no semen comes out), or pain during sex.
Everyone’s experience is unique and it is helpful to talk with your providers about what to expect and how to manage symptoms.
When should I start thinking about sex after cancer?
Coping with cancer can be stressful and scary. Sometimes people decide to wait until after treatment is complete to resume a sexual relationship. Other people may seek comfort from intimacy right away. It is best to talk with your providers (and your partner!) about when it is safe to have sex and what you may need to prepare for. For females undergoing radiation therapy to the pelvis, it is important to take steps right away to prevent fibrosis and permanent changes to the vagina. Similarly, in males, early intervention helps prevent long-term side effects.
Resources
Book:
“Come As You Are: The Surprising New Science That Will Transform Your Sex Life,” by Emily Nagoski
Websites:
www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/how-cancer-affects-sexuality.html
www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-women-with-cancer/pelvic-surgery.html
www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-women-with-cancer/faqs.html
www.aftercancer.co/resources/
www.cancer.net/navigating-cancer-care/dating-sex-and-reproduction/sexual-health-and-cancer-treatment-women
www.cancer.net/sites/cancer.net/files/asco_answers_sexual_side_effects.pdf
These recommendations have been developed to be inclusive of individuals of all sexual and gender identities to the greatest extent possible. In this guideline, the terms male and female refer to the sex assigned at birth.