Receiving a cancer diagnosis of any kind can be very difficult and distressing, both for the patient and their loved ones. Naturally, pursuing treatment for the cancer is usually an individual’s top priority at the time of diagnosis, often overshadowing other concerns and lifestyle considerations. As such, many patients are unaware that cancer and its treatment can affect their sexual function until they are in the midst of it.

While it is true that cancer treatments like surgery, radiation therapy, chemotherapy, and hormone therapy can cause changes to a person’s sexuality, there are ways to mitigate the negative effects and continue to be intimate with one’s partner. It is important to note that some changes to sexual function are permanent, but others are temporary and may improve over time. Regardless, being knowledgeable about the changes that could occur can help a person be better prepared to face them and find ways to maintain a satisfying sex life after cancer.

Physical Side Effects of Cancer Treatment that Impact Sexual Function

While the side effects of cancer treatment vary from person to person and depend on the type of cancer being treated, the following are the most common ways in which treatments can physically impact sexual function:

• Cancer treatments can cause extreme fatigue, sometimes resulting in a person not having the energy for sex.
• Hormone therapy and chemotherapy both alter a person’s hormone levels, which can lead to a decreased libido (sex drive). Generally, a person’s sex drive comes back once treatment is complete.
• Chemotherapy can also cause nausea, vomiting, diarrhea, constipation, and ulcers, all of which may temporarily decrease a person’s desire to have sex.
• When cancer affects the genitals or other reproductive/sex-related organs, surgery to remove the cancer will likely impact sexual function. Surgeons strive to keep as much of the healthy tissues as possible when removing the cancer to limit the negative effects.
  • For men, the surgical removal of the prostate or the partial or full removal of the penis can cause erectile difficulties or make it impossible to get an erection. The removal of one or both testicles can cause hypogonadism, a condition in which the body produces little or no testosterone. Hypogonadism can result in decreased libido and/or erectile dysfunction (ED). Finally, the removal of part or all of the anus can result in the inability to have receptive anal intercourse, which may be important for some men who have sex with men.
  • In women, the surgical removal of both ovaries causes early menopause (for women who have not gone through it already). Some symptoms of early menopause may include vaginal dryness and/or a lack of interest in sex. Partial or full removal of the vulva can cause changes in sexual sensation, as can the removal of a section of the vagina. Surgery to remove some or all of one or both breasts can sometimes result in a feeling of loss of femininity. The removal of both breasts may represent the loss of an important erogenous zone for women.
• Radiation therapy in the general region of the genitals can sometimes cause temporary or permanent ED in men. It may also decrease the volume of ejaculate released during orgasm.
• Women receiving radiation therapy aimed at the pelvis may experience early menopause caused by damage the ovaries. Radiotherapy in this area may also inflame the vaginal tissues, causing them to tighten and become less flexible, which can make sex painful.

Mental Side Effects of Cancer Treatment that Impact Sexual Function

People undergoing cancer treatment may also struggle with mental health issues and feelings of anger, grief, anxiety, fear, and depression. If the cancer treatment changes the way a person looks, (e.g., hair loss or the removal of a body part like the breasts or testicles,) he or she may also feel self-conscious, less attractive, or less sexually desirable, even when the change does not bother their partner. If the cancer treatment causes changes in a person’s sexual function, he or she may feel guilt, shame, and/or worry about the impact it may have on their partner. All of these emotions are a natural response to the big life changes that come along with cancer and its treatment. However, it is important that they are addressed in a healthy way, or they could potentially become damaging to a person’s relationships and sex life. (See the article “Do Mental Health Problems Have an Effect on Sexual Function?” for more information). 

How to Lessen the Impact of Cancer Treatments on Sexual Function

Learning how cancer treatments can affect sexual function is understandably upsetting for many people, but having knowledge on this topic is the first step toward lessening the impact. Again, some changes to a person’s sexuality caused by cancer treatments are temporary and may go away once treatment is stopped. Here are some ways to maintain intimacy with your partner and support your sexual function after cancer:

• Talk to your health care providers about your sexual health and functioning and ask for resources. Health care professionals know that sexual function is important, but they may not always bring it up if they are busy addressing other concerns. It is completely reasonable to bring up sexual health matters with your provider. If your provider does not have the answers to your questions, they can refer you to a sexual medicine specialist.
• Maintain open, honest communication with your sexual partner. This can help a couple navigate changes in sexuality together.
• Experiment with new or different sensual/sexual activities as a way to nurture intimacy with your partner. Sex can still be enjoyable even when there have been changes to a person’s sexual function.
• Involve a mental health professional like a sex therapist to help you and your partner process the changes in your sex life and the feelings that come along with these changes.
• Talk to other cancer survivors. This can help a person feel less isolated and supported by a community of people who have been through something similar.

Resources:

• Cancer Council Victoria. (n.d.). Sexuality and intimacy. Retrieved January 24, 2022, from https://www.cancervic.org.au/living-with-cancer/sexuality-and-intimacy/treatment-and-its-effects
  
  
• Mayo Clinic. (2020, April 18). Cancer treatment for men: Possible sexual side effects. https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-treatment/art-20045422
  
  
• Mayo Clinic. (2020, June 6). Cancer treatment for women: Possible sexual side effects. https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-treatment/art-20047214