How Will Cancer and Cancer Treatment Affect Your Sexual Health?

Talking about sex can be a sensitive topic. It is important, however, to discuss how cancer and cancer treatment can affect sexuality and how to treat issues that may develop. It may help to write down your questions before you see your doctor. Here are some questions to get you started.

• Will I be able to have children after this cancer treatment?
• Are there steps I can take to preserve my fertility?
• Is it safe to have sex while I am going through chemotherapy? What precautions do we need to take?
• Can chemo be passed through bodily fluid during sex?
• Is it possible to get pregnant while on this treatment? Would there be any increased risks or negative effects on the baby?
• Should I stop my birth control or continue it?
• What method to prevent pregnancy would be right for me?
• Will this treatment have effects on sexual function?
• What can I do to treat vaginal dryness?
• Can anything be done about low interest in sex?
• Are any of my medications impacting my libido?
• Can I have help for my body image?
• Sex has become painful. Is there anything that can help?
• What is pelvic floor physical therapy, and would it be helpful for me?
• Can I see a specialist to help me with my sexual health?

More cancer patients in Louisville and Southern Indiana choose Norton Cancer Institute, where they find sophisticated expertise, including access to innovative clinical trials, and a commitment to treating the whole person — not just the cancer.

Cancer and cancer treatments can bring on sexual health changes, many of which can be treated.

Cancer Treatment and Early Menopause

Surgery, chemotherapy, radiation or hormone-blocking treatments can trigger menopause in cancer patients. This can cause infertility and also cause symptoms that can affect sexual health.

Many symptoms of menopause can affect sexual health, such as:

• Hot flashes
• Night sweats
• Fatigue
• Vaginal dryness
• Pain with sex — this needs to be evaluated by a medical professional
• Decreased libido or desire
• Joint aches
• Mood changes
• Insomnia
• Anxiety or depression
• Foggy thinking
• Urinary tract infections
• Infertility

Cancer and Sex Drive

Reduced sex drive is a very common concern after cancer treatment. Contributing factors can include biological, psychological, social and cultural causes.

• If sex is painful, then desire likely will decrease. The first step is to address the cause of painful sex.
• Chronic nonpelvic pain can increase stress, contribute to depression and decrease libido.
• Cancer surgery can alter sexual identity and body image.
• Cancer survivors who have experienced sexual trauma in the past may have increased challenges.
• Depression, anxiety, medication side effects and chronic fatigue from cancer treatments can all reduce desire for sex.
• Your partner may have their own sexual health concerns.

Improving Your Libido

• Mindfulness and meditation can help reduce stress and connect you to the present.
• Regular exercise may help improve libido.
• Spending 15 to 20 minutes in foreplay may help improve interest in sex.
• Familiarizing yourself with your body and what you like, exploring your own body and using sex toys may help libido.
• Connecting with your partner emotionally can improve desire and interest in sex. Plan ahead for a time for just the two of you, and put stressful topics off limits for that time.
• Pick a time for intimacy when you have more energy and plan ahead.
• Share your feelings and listen to your partner.

Treatments for low desire include:

• Treatment of underlying physical issues
• Psychosocial counseling
• Sex therapy

Two medications, flibanserin and bremelanotide are approved to improve sexual desire in women, although they have not been studied in cancer patients.

Painful Intercourse

Painful intercourse after cancer treatment is a common issue and can be treated. There are several reasons a person may have pain with sex after cancer treatment.

• Vaginal dryness. Use of vaginal moisturizers and lubricants can relieve vaginal dryness. In some cases, your cancer care provider may recommend topical estrogen.
• Pelvic pain syndrome. Pain can occur around the outside of the vagina or on the inside with penetration. The muscles of the pelvic floor can be overactive, and this can cause pain with sex and other issues. A pelvic floor physical therapist can work with patients to relieve pelvic floor pain.
• Vaginal stenosis. Shrinking and shortening of the vagina can result after some types of cancer treatment. Using progressive vaginal dilators and working with a pelvic floor physical therapist can treat this condition.
• Vaginismus. An involuntary contraction of vaginal muscles that makes vaginal penetration difficult. This can interfere not only with sexual activity, but with medical exams or the use of a tampon. Pelvic floor physical therapy or working with a sex therapist can help improve this issue.

Body Image

Body image involves your perception, thoughts, behaviors and emotions related to your body. It is more than just physical appearance. Cancer and cancer treatment can cause physical changes such as loss of a body part, hair loss, weight changes and scarring that affect body image. Many of these changes may be linked to how one views sexuality.

Body image concerns are common after cancer treatment and can come up at different times.

Ways to address body image concerns:

• Talk about body image concerns with family and friends. Ask them to listen, not to give you advice.
• Wigs, scarves and hats can help you cope with hair loss. A wig can be prescribed by your medical provider and may be covered by insurance. Norton Cancer Institute Resource Centers have resources for wigs as well.
• Breast prostheses and specialized bras can be prescribed by your medical provider after breast surgery and may be covered by insurance.
• Counseling can be very helpful in restoring a positive body image.

Vaginal Dryness

If vaginal moisturizers and lubricants don’t work for you, or you have more severe vaginal dryness or pain, talk to your cancer care provider. Vaginal moisturizers and lubricants serve different purposes.

Moisturizers help treat dryness and improve vaginal tissue. They should be used regularly — at least three times a week at bedtime. Moisturizers often are oil-based.

Lubricants work to reduce friction or pain caused by rubbing against dry and thin vaginal tissue. Lubricants can be oil-based, water-based or silicone-based.

• Moisturizers and lubricants do not protect against pregnancy and sexually transmitted infections.
• Water- and silicone-based lubricants can be used with condoms.
• Oil-based lubricants can make condoms less effective. Do not use petroleum jelly or baby oil as lubricants.
• Oil- and silicone-based lubricants can stain sheets. If you are concerned about staining, place a towel over the sheets.
• Silicone-based lubricants can damage silicone sex toys.
• Lubricants that are flavored, tingling/warming or contain glycerin can cause vaginal irritation.