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Home > Wellness Resources > Health Library > Sexuality and Reproductive Issues (PDQ®): Supportive care - Patient Information [NCI]
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
Many types of cancer and treatments for cancer can cause sexual side effects.
Many types of cancer and cancer treatments can affect sexual function. These changes may be temporary or permanent. Sexual problems are common in patients with the following types of cancer:
Less is known about how other types of cancer affect sexuality.
Both sexual desire and ability can be affected.
The most common sexual problems for cancer patients include the following:
Less common problems in men include the following:
Less common problems in women include the following:
Unlike many other physical side effects of cancer treatment, sexual problems may not get better within the first year or two after cancer treatment. The problems may get worse over time and can get in the way of returning to normal life. That is why it is important to get help with learning to adapt to changes in sexual function.
You and your partner decide what is normal for you.
Sexuality involves both the body and the mind. "Normal" sexual functioning covers a wide range. You and your partner define what is normal for you. Your "normal" may be affected by the following:
Sexual function can be an important part of your quality of life. Talk with your doctor if you have problems or concerns about your sexual function. If your doctor cannot talk with you about sexual problems, ask for information from other places or for the name of a doctor who is comfortable talking with you about them.
Certain cancer treatments can affect sexual function.
Surgery for the following cancers can cause body changes that have sexual side effects:
For both men and women, chemotherapy is linked to loss of sexual desire and having intercourse less often. Common side effects of chemotherapy can affect your sexual self-image and make you feel unattractive. Side effects may include the following:
In women, chemotherapy can cause the following problems:
Older women who receive chemotherapy have an increased risk of ovarian cancer.
In men, chemotherapy can cause the following problems:
Radiation therapy can cause side effects that may decrease sexual desire. Side effects may include the following:
In women, radiation therapy to the pelvis can cause changes to the lining of the vagina. The vagina may become narrow and scar tissue may form, which can cause pain with intercourse, painful pelvic exams, infertility, and other long-term problems.
In men, radiation therapy can cause problems getting and keeping an erection. Sexual changes happen slowly over six months to one year after radiation therapy. Men who had problems with erectile dysfunction before getting cancer may be more likely to have sexual problems after being diagnosed and treated for cancer.
Other risk factors in men that cause sexual changes include the following:
Hormone therapy can stop or slow the growth of certain cancers, such as prostate and breast cancer. This is done by using hormones made in a laboratory or other drugs to block the body's natural hormones. However, lower hormone levels can cause sexual problems.
Men who get hormone therapy for prostate cancer may have the following problems:
Women older than 45 years who are treated with tamoxifen may have slightly more of the following problems:
Other drug therapy
Drug therapy, such as opioids for pain and drugs to treat depression, can cause sexual side effects. Cancer patients may get drug therapy that affects the nerves, blood vessels, and hormones that control normal sexual function. Drug therapy may also affect their alertness and moods.
Your thoughts and feelings can affect your sexual function.
Misbeliefs about cancer might make you confused or unsure about sex when you are recovering from cancer. Common misbeliefs about cancer include the following:
Misbeliefs like these can keep you from enjoying sex again. Talk with your doctor to find out the facts so that you can feel more comfortable.
Depression is more common in cancer patients than in people who do not have cancer. Common symptoms of depression include loss of sexual desire and a decrease in sexual pleasure. Treatment for depression may lessen your sexual problems. (See the PDQ summary on Depression for more information.)
Cancer and cancer treatment may cause physical changes, such as hair loss or weight gain from chemotherapy or body changes from surgery. You may not like how you look and you may not want to have sex. Let your health care team know your concerns. You can get help adjusting to body changes caused by cancer and its treatment.
Patients with colostomies or ileostomies need to find a sexual position that does not place weight on the ostomy. Information is available from national organizations related to sexual function.and ostomates.
The stress of cancer diagnosis and treatment can make relationship problems that you already have even worse. Your sexual relationship can also be affected. Patients who do not have a committed relationship may stop dating because they fear being rejected when a new partner finds out they have cancer. Your feelings about your sexuality before being diagnosed with cancer will affect adjustment after cancer treatment. If you had positive feelings about sex, you may be more likely to continue sex after cancer treatment. Cancer can be hard on any relationship. It is important to get help if stress is causing a problem for you.
Your doctor will talk with you to find out what may be causing your sexual problems and how these problems affect your life.
As part of the assessment, your doctor will talk with you alone or with both you and your partner. You may be asked the following questions:
Your doctor may ask questions about your relationship with your partner.
You may be asked the following questions if you have a partner:
You and your partner may have sexual problems and concerns and fears about your relationship. It is important that you and your partner talk about these things with a doctor you feel comfortable with.
Your doctor may also ask you about your lifestyle.
You may be asked the following questions about your lifestyle:
Sexual assessment may include a physical exam and other tests.
The following tests and procedures may be done:
Good communication can help you and your partner continue sex after cancer treatment.
You may be afraid or anxious about having sex after cancer treatment. Fear and anxiety can cause you to avoid intimacy, touch, and sexual activity. Your partner may also be afraid and anxious that starting sexual activity will make you feel pressured or cause you pain. Even when a couple has been together a long time, talking about these things is important. Honest communication of feelings, concerns, and preferences can help.
You can learn ways to adapt to changes in sexual function.
Health professionals who specialize in treating sexual problems can give you the names of organizations that offer support. They can also tell you about educational materials such as Internet sources, books, pamphlets, and DVDs. These resources can help you learn ways to adapt to changes in sexual function.
Counseling may make it easier for you to cope with changes in your body and your sex life after cancer.
Sexual counseling may help you. Counseling may be for you alone, with you and your partner, or in a group.
Medical treatments may help improve sexual function.
You may be helped by medical treatments such as hormone replacement, drugs, medical devices, or surgery.
Cancer treatments may cause infertility.
Radiation therapy and chemotherapy may cause infertility (being unable to have children). This may be temporary or permanent. The risk of infertility as a side effect of cancer treatment depends on the following:
Ask your doctor if your cancer or its treatment may cause infertility or sexual side effects. Your doctor can tell you what changes may happen. A child may be too young to understand issues about infertility or sexuality. Parents can decide what they want their child to know about these issues.
If you are concerned about your ability to have children, find out what you can do before treatment.
Talk to your doctor before treatment if you are concerned about the effects of cancer treatment on your ability to have children. Your doctor can recommend a counselor or fertility specialist who can tell you your options and help you and your partner make a decision. Options may include freezing sperm, eggs, or ovarian tissue before cancer treatment.
Chemotherapy can affect fertility.
The following chemotherapy agents have been shown to affect fertility:
Fertility is likely to get better the longer you have been off chemotherapy. If you are taking chemotherapy, your age is an important factor. In women older than 40 years, adjuvant hormone therapy increases the risk that chemotherapy will cause infertility.
Radiation therapy to the abdomen or pelvis can cause infertility.
A man's age and the amount of radiation given directly to the testicles affects his risk of infertility. Lower doses of radiation and using lead shields to protect the testicles can help men keep their fertility. Sperm counts usually take 10 to 24 months to return to the level they were before radiation therapy. Usually, the higher the radiation dose, the longer it takes to recover. If the body is not making hormones normally, hormone therapy may help restore fertility. Radiation given to boys who have not reached puberty can cause problems with fertility.
Radiation therapy to the ovaries may cause infertility in women of any age. High doses of radiation in women younger than 26 years may cause early menopause. Lower doses of radiation can cause infertility in women older than 40 years. Regaining fertility is more likely if radiation to the ovaries is given before puberty. Doctors are sometimes able to protect the ovaries during radiation therapy.
Check NCI's list of cancer clinical trials for U.S. supportive and palliative care trials about sexuality and reproductive issues, sexual dysfunction, fertility assessment and management and cryopreservation that are now accepting participants. The list of trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
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This PDQ cancer information summary has current information about sexuality and reproductive issues that cancer patients may experience during or after treatment. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
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Last Revised: 2013-12-09
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