Many cancer treatments and some types of cancer can cause sexual and fertility-related side effects. Some cancer treatments also can cause premature (early) menopause—when a woman stops menstruating (getting her period)—which can impact your sexuality. Whether you have these problems can depend on the type of treatments you receive, your age at time of treatment, and the length of time since treatment. Many women find it helpful to talk with their doctor or nurse about sexual problems they may have during and after treatment. Learning about these issues will help you make decisions that are best for you.
Sex and sexuality are important parts of everyday life. You can get help if you are having sexual problems after cancer treatment.
About 50% of women who have had breast cancer or gynecologic cancer experience long-term sexual problems.
Cancer Treatments and Sexuality
Cancer treatments such as chemotherapy, hormone therapy, radiation therapy to the pelvic area (vagina, uterus, or ovaries), and surgery for cancers of the uterus, bladder, vulva, endometrium, cervix, or ovaries may cause sexual side effects. Many of these treatments may cause symptoms of early menopause, including hot flashes and vaginal dryness.
Learn more about problems affecting a woman’s sexuality:
- Check this table from the American Cancer Society for a list of some common cancer treatments and how they can cause female sexual and fertility problems.
- Find several resources on sexuality and reproductive issues affecting cancer patients available from the National Cancer Institute.
Dealing with Sexual Problems
Many women have concerns about their sexual health and abilities during and after treatment. Some cancer patients worry that when they resume sexual activity, it will be painful or won’t result in orgasm. But you can relearn how to feel pleasure after cancer treatment.
Talk to Your Health Care Team
Talk with your health care providers before you start treatment to learn what to expect based on the type of treatment you will be receiving. Get answers to questions about:
- Sexual activity
- Birth control
- Condom use
Sex-related questions you might want to talk to your doctor about during cancer treatment could include the following:
- What problems or changes might I have during treatment?
- How long might these problems last? Will any be permanent?
- Is there treatment for these problems?
- Would you give me the name of a specialist that I could meet with?
- Is there a support group for women that you would recommend?
Get Professional Help for Sexual Problems
Consider seeking help from a medical or sexual health professional for advice on sex-related questions during and after treatment. Your doctor may be able to help you or could refer you to a special program or a specialist, such as:
- Sexual rehabilitation programs in cancer centers
- Sexual medicine clinics or sexual health clinics
- Sex therapists
- Other kinds of counseling, from a psychologist or social worker
- Other medical specialists, including a gynecologist
Talk to Your Partner
Good communication is important to maintain a healthy sexual relationship. When talking to your partner, be honest and have a positive attitude, instead of making demands or accusations.
Tips for Dealing with Sex and Cancer
Check out the online guide “Sexuality for the Woman with Cancer” for an overview of some of the more common changes and what you can do to manage them. You can also follow the tips below for navigating sexual interaction during and after cancer treatment.
Practice Safer Sex
- Because chemotherapy drugs can be present in vaginal fluid, use condoms while you are getting chemotherapy and for about 2 weeks afterward.
- Some cancer treatments may cause harm to the fetus if you get pregnant, so be sure to use birth control if you are sexually active.
- Take precautions, such as using condoms or dental dams, if you are unsure if you or your partner has a sexually transmitted disease.
When Not to Have Sex
Ask your doctor if sexual activity could be a problem at any time during or after your cancer treatment. Here are some guidelines:
- Sex after surgery can cause bleeding, strain the incision (cut), or increase your chance of infection.
- Stop having sex if you are bleeding in the genital area or urinary tract (you may see blood in your urine).
- Radiation therapy or chemotherapy may weaken your immune system, making it easier for you to get infections. Stop having sex if you’re hospitalized for weak immunity.
- If you see any sores, bumps, or warts on your partner’s genitals, or any unusual fluids or discharge, ask your partner about it and ask whether it’s safe to have sex.
Sex During Advanced Cancer
Sexual feelings exist in everyone, even in times of poor health. Even if your cancer is advanced and sexual intercourse might be too much to handle, you may still want or need to feel affection and physical closeness.
Menopause is the time in a woman’s life (typically between 45 and 50 years of age) when she stops menstruating (getting her period). Some cancer treatments can cause premature (early) menopause. Symptoms can be more abrupt and intense than the slow changes that happen during a natural menopause, and they can have an impact on your sexuality.
Common symptoms include the following:
- Frequent hot flashes, especially at night
- Vaginal dryness
- Irregular or no periods
- Mood changes
- Reduced interest in sex
There are risks and benefits to trying hormone therapy to help manage menopausal symptoms. Talk to your cancer care team to find out if hormone therapy is a good option for you.
- Hormone therapy can help with vaginal dryness and hot flashes, but this treatment is linked with some kinds of cancer and other health problems.
- If you and your doctor agree to use hormone therapy, start by taking a low dose for a short period. See what works best for you. Be sure to check in with your doctor each year.
For Hot Flashes
- Try exercise and relaxation techniques to treat mild hot flashes.
- Ask your doctor about medicines and non-drug treatments that may help with symptoms.
For more detailed information on support options, visit Get Support.
Talk to Your Health Care Team
Your health care team needs to know how you’re doing. Be sure to tell them about any changes you notice.
Talk to Family and Friends
Your loved ones want to support you. They can help with activities like housework, running errands, and getting to appointments. Be as specific as possible about the kind of help you need.
Find Peer Support
Talk About Your Concerns
Peer groups offer a welcoming environment to share your feelings and experiences with people who are going through the same things. Use the American Cancer Society’s Resource Search to find a peer group in your area or call the American Cancer Society at 1-800-227-2345 for personalized assistance.
Visit the Cancer Survivors Network Online
The Cancer Survivors Network is an online community with more than 40 discussion boards where cancer survivors share their cancer-related experiences, support one another, and exchange practical tips.
NCI Cancer Information Service
Speak to a National Cancer Institute health information specialist by calling 1-800-4-Cancer.
The National Cancer Institute offers live, online assistance through its LiveHelp service.
ACS National Cancer Information Center
Get information and tips from a cancer information specialist at the American Cancer Society by calling 1-800-227-2345. Lines are open 24 hours a day, 7 days a week.
The American Cancer Society offers live, online assistance 24 hours a day, 7 days a week. Select the Live Chat option from any page on cancer.org.
Learn More About Sexual Problems
The National Cancer Institute and the American Cancer Society have additional resources to help you understand and cope with sexual dysfunction, including sexual side effects in women and sexual and fertility problems (women).