Sexual Health and Cancer

Why sex is important

Sex is an important part of people's lives; it helps develop emotional and physical closeness and builds intimacy in relationships. While sex can help people with cancer cope with the challenges they face, cancer and cancer treatments can greatly impact sexuality and sexual expression. The effects of cancer on sexuality can range from issues in sexual function, change in body image, loss of libido, and hormone changes. Most people who are going through cancer treatment experience some type of difficulty with sex during, and sometimes even after, treatment, including surgery.

How does cancer treatment affect sexuality?

Cancer treatment can affect sex, sexual desire, and sexual expression both physically and psychologically, so it is important to talk to your healthcare team about it. Some treatments affect how the body works by changing hormone levels, or there can be damage to nerve function that can change sexual sensations. Treatment side effects like fatigue, nausea, bowel or bladder problems, pain, and skin problems or other changes in appearance might also cause problems with sexuality.

There may be a loss of desire for sex even if there are no physical symptoms associated with it. The psychological toll of a cancer diagnosis and treatment process can contribute to a loss of libido. It is important to remember that these issues are not caused by you, but rather by what your body is going through at this time. Some sexual problems get better or go away over time, but some may be long-lasting. Talk to your healthcare team for guidance on these issues.

How to talk about sex and cancer

You may need to proactively bring it up with your doctor even if it feels uncomfortable. It is important to have the conversation so you can understand what to expect and where you can go for help if you are facing difficulties.

There are multiple doctors that may be involved in helping you. Cancer and cancer treatment affect different parts of your body so you might meet with multiple specialists like urologists, gynecologists, physical therapists, nurses, mental health providers, or sex therapists. If you want to know more about the various specialists that may be on your healthcare team, check out our Creating Your Cancer Treatment Plan article.

Here’s a list of questions that can help you get the conversation started with your healthcare team:

• What sexual problems are common when receiving this treatment?
• What sexual changes might I experience during treatment?
• When might these changes occur? How long might these last?
• Are there times when I should avoid sexual activity?
• Will any of these changes or problems be permanent?
• How can these problems be prevented, treated, or managed?
• What specialist(s) would you suggest that I talk with to learn more?
• Are there support groups for people experiencing these issues or changes?
• (If applicable) What precautions do I need to take during treatment including birth control and/or condoms?

What you can do

If you are facing any sexual dysfunction as a result of cancer treatment, the most important part is getting help. Talk to your healthcare team for guidance on these issues. If you can get more specific in explaining the issue, your care teams will be more effective in helping you. There are a variety of treatments and medicines that can help with the physical issues you may experience. For issues that are more psychologically based like anxiety, you can find support by talking to your healthcare team about therapy and counseling.

If you have a partner

Talk to them about your fears or concerns around sex and cancer. Communicating with a supportive partner can help you feel more reassured. There may be changes that the both of you will need to adapt to, and you may need to find new ways to be intimate. You can explore new ways of touching each other and find pleasure in that. Alternatively, you can build intimacy by focusing on each other and spending quality time together doing activities that are not focused on being sexual, like listening to music together, taking walks, hugging, and cuddling. Do your best to focus on the positive things in your relationship, and take your time to discover what works for the both of you during this challenging time.

If you are single and dating

It may be uncomfortable to approach the topic of cancer and the effects of cancer treatment on a date or in a new relationship. You may experience rejection; however, as a cancer survivor, you should not expect to have any more problems finding a date than people without a history of cancer.

When you decide to date, it is up to you how and when to bring up the topic of cancer with the new person in your life. Wait until you have a sense of trust with the person before talking to them about it. Even if dating feels challenging, don’t let cancer be the cause for not dating and meeting people. If you feel uncomfortable, talk to your friends and family about your experiences. You can also find support groups for people who have cancer and are dating.

If you are a caregiver and a partner

It is difficult to witness a loved one go through treatment for cancer, and it can also be very difficult to switch between the roles of caregiver and partner or lover. Remember, each cancer survivor is different and some may be craving more physical contact as they go through treatment, or they may have lost interest in sex during this time. It’s important to support your partner by accepting where they are and never pressure them to have sex. Additionally, it is important that caregivers look after themselves by taking breaks from caregiving, if possible. It may also help to talk about their experience, frustrations, or concerns with trusted loved ones outside the couple for additional support.

When transitioning from caregiver to partner as a couple, it may help to change the physical setting to get into a different mindset. If possible, try going away for a weekend or going out on dates out of the house to relax and focus on each other. Continue to express your feelings and what you are going through with each other. The open communication may help both of you cope with the changes in your relationship. Take things slow and be patient as you find new ways of connecting. Intimacy and sexual issues are common during the journey with cancer, and it will take time to discover what works for the both of you.