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Sex can feel like a taboo topic for anyone, but sex and other forms of intimacy are important parts of a relationship, including for people with cancer. Cancer itself and certain treatments can have temporary or permanent physical and emotional impacts that affect a person’s sex organs, fertility, relationship with their body, ability to become aroused, and desire to want to be intimate with their partner.
Sexual health resources are available to help people living with cancer maintain an active sex life. Talking about sex and sexual intimacy with experts in Huntsman Cancer Institute’s Sexual Health and Wellbeing Clinic lets patients learn about options and what they can expect during and after treatment.
Cancer Types and Treatments that Affect Sex
Engaging in sexual activity may look different for people with cancer, and that’s OK. How cancer affects a person’s sex life may depend on what type of cancer they have and the treatment they go through.
Common types of cancer that may impact sex, sex drive (libido), fertility, and body image include breast; prostate; leukemia; anal; and reproductive cancers such as gynecologic, penile, and testicular cancer. Other forms of cancer may also impact a person’s sexual health and sex life.
People with the highest risk for testicular cancer are those between the ages of 18 and 35, and we're not always thinking about cancer in that age group.
Cancer treatments can affect a person’s sex life during treatment and long term. Surgery, radiation, chemotherapy (or chemo), and hormone therapy are common types of treatment for cancer. Patients should ask their doctor if and how long they should wait to engage in sex after receiving certain treatments.
- Surgery may change a person’s physical appearance, sex drive, or ability to reproduce.
- Radiation to the pelvic area may cause vaginal bleeding or discomfort during sex.
- Chemotherapy and hormonal treatments can affect appearance and sex organs by reducing hormone levels. This can lead to changes in the ability to create eggs and sperm, and it may cause reactions to mucus membranes in the mouth and vagina, making sex painful. Patients should ask their doctor whether having sex raises the risk of infection.
One of the reasons breast cancer is so frightening is because the breasts are an important part of our appearance and an important part our sexual intimacy with our partners.
People with cancer should talk to their cancer care team before treatment begins to learn about possible outcomes and ask questions. A person’s ability to have children or become pregnant, called fertility, can be impacted by cancer and certain treatments. It is extremely important for people with cancer to talk with their doctor about fertility before cancer treatment. Here are a few examples of questions to ask:
- What are my options?
- How much time do I have before I start treatment?
- How will I know if I am fertile after my cancer treatment?
- How do I know when it is safe to try having a baby?
- Will there be any health risks to me or my future children?
- What can be done to help protect my fertility?
Huntsman Cancer Institute works with the Utah Center for Reproductive Medicine at the University of Utah to help people with cancer who want to have children after treatment.
There are many physical, physiological, and emotional side effects during cancer treatment that can change a person’s sex life. Many patients with cancer have feelings and emotions that reduce sex drive such as stress, fatigue, depression, anxiety, and changed appearance.
- For people with penises: genital discomfort, pain during ejaculation, or difficulty having or keeping an erection, or fertility changes
- For people with vaginas: dry vagina, abnormal vaginal discharge or lack thereof, bleeding before or after sex, or fertility changes
Pregnancy during cancer treatment can harm the fetus. It is important for those undergoing cancer treatment to use effective forms of birth control. Most doctors recommend using two methods to avoid pregnancy. Patients may not be able to use some types of birth control such as birth control pills and should talk to their care team about the best and safest methods of birth control.
While undergoing treatment, bodily fluids may contain traces of cancer medication. This can pose a risk to sexual partners. Patients should talk to their doctors to learn if the medicines taken pose this risk. Learn more about how to protect yourself and your partner through the Sexual Health during and after Cancer Treatment fact sheet.
Those who have had cancer treatment may experience temporary or permanent sexual side effects. These changes can impact a person’s relationship with themselves in and outside of the bedroom and with any sexual partners.
After cancer treatment, patients should continue having follow-up visits with their cancer care team or their primary care physician for medical advice regarding their sexual health and fertility. People should talk to their cancer care team about how long after treatment they should avoid getting pregnant. Most patients need to avoid pregnancy for six months to one year after completing cancer treatment. The time may be shorter or longer, depending on the situation. Cancer treatment may also permanently affect one’s ability to get someone or become pregnant. For this reason, it is critical to talk about fertility before cancer treatment begins.
Sexual Health Resources
Some sexual side effects during or after cancer treatment can make sex painful. There are many resources available for people assigned female at birth to help make sex more enjoyable. These include medications, lubricants, moisturizers, and vaginal dilators. Lubricants and moisturizers can be found at pharmacies and online. Dilators can be purchased at specialty shops or online. Additional information can be found on our Women’s Sexual Health after Cancer Treatment fact sheet. These do not prevent pregnancy or sexually transmitted infections.
- Vaginal lubricants work immediately to ease dryness during sex and can be placed in and round the vagina, on penises, other body parts, or other instruments that go into the vagina. Use water- and silicone-based lubricants instead of oil-based or other products that have glycerin or flavors as these can be irritating.
- Vaginal moisturizers help to ease dryness when not having sex and should be used often, up to three times per week. Oil-based moisturizers are OK for people with no history of urinary tract infections, yeast infections, or diabetes.
- Vaginal dilators can be used to gently stretch the vagina slowly over time and should be used with a vaginal lubricator.
Sexual Health and Wellbeing Clinic
Patients assigned female at birth with cancer who have questions or are seeking sexual health resources can schedule an appointment with a provider at The Sexual Health and Wellbeing Clinic. This clinic provides a safe place for patients to talk about sex and sexual health. Providers can discuss how to prevent side effects and improve sexual function, plus offer treatment options and sexual health counseling. This can help patients learn new ways to cope with physical changes, deal with stress, strengthen intimate relationships, and grieve the loss of their health.
To schedule an appointment, patients may fill out the Appointment Request form or contact the scheduling coordinator:
Patient and Family Support social workers and groups
Utah Center for Reproductive Medicine