Think Beyond Cancer
Sexuality & Cancer

Sex might be the last thing on your mind as you start thinking about cancer treatment options and begin coping with the anxiety that comes with a cancer diagnosis. But as you start to feel more comfortable during cancer treatment and afterward, you'll want to get back to a "normal" life as much as you can. For many, this includes resuming sexual intimacy.

During the treatments, you can suffer from a decrease of the desire, which is most of the time usual and temporary. This block can be physical and psychological. For cancers affecting the pelvis or the abdomen, treatments can prevent from sexual relations for some time.

An intimate connection with a partner can make you feel loved and supported as you go through your cancer treatment. But sexual side effects of cancer treatment can make resuming sex more difficult. Find out if you're at risk of sexual side effects after cancer treatment and which treatments can cause these side effects.

Who's at risk of sexual side effects?

Women with the greatest risk of sexual side effects include those being treated for:

  • Bladder cancer
  • Breast cancer
  • Cervical cancer
  • Colon cancer
  • Ovarian cancer
  • Rectal cancer
  • Uterine cancer
  • Vaginal cancer

Treatment for each of these cancers carries the risk of causing physical changes to your body. But having cancer also affects your emotions, no matter what type of cancer you have. For instance, you may feel anxious and worn out about your diagnosis, your treatment or your prognosis. These emotions can also affect your attitude toward sex and intimacy with your partner.

What sexual side effects are most common?
The treatment you receive and your type and stage of cancer will determine whether you experience sexual side effects. The most commonly reported side effects among women include:

  • Difficulty reaching climax
  • Less energy for sexual activity
  • Loss of desire for sex
  • Pain during penetration
  • Reduced size of the vagina
  • Vaginal dryness

Not all women will experience these side effects. Your doctor can give you an idea of whether your specific treatment will cause any of these.

In case of men, Pelvic cancers are most likely to cause sexual dysfunction than other cancers

Men with cancer in their pelvic area are more likely than are men with other cancers to report difficulty resuming sex after cancer treatment. Sexual side effects are most common after treatment for:

  • Bladder cancer
  • Colon cancer
  • Prostate cancer
  • Rectal cancer

Older men are more likely to experience sexual dysfunction after cancer treatment. That's because older men will experience difficulty with sex at some time. So older men who've had cancer treatment may experience sexual side effects related to aging, rather than treatment. Or they may find that cancer treatment accelerates the sexual side effects associated with normal aging.

Erectile dysfunction: Most common sexual side effect of cancer treatment for men

A number of sexual side effects can occur as a result of cancer treatment, including:

  • Inability to achieve or maintain an erection (erectile dysfunction)
  • Difficulty climaxing
  • Orgasm without discharge of semen (dry orgasm)
  • Weaker, less satisfying orgasms
  • Loss of libido
  • Pain during sex
  • Less energy for sexual activity

Not every man with cancer in his pelvic area will experience sexual side effects. Your doctor can discuss the level of risk you may encounter for your specific treatment.

You might experience sexual side effects even before you begin your treatment or even if you're being treated for a cancer that doesn't affect your pelvic area. For instance, fatigue, pain, anxiety about your treatment or depressed feelings about having cancer could cause a loss of libido. Sometimes emotional factors may have sexual side effects in addition to the physical changes you undergo during treatment.

Resumption of sexual life in a man

Testicle cancer:If one testicle is removed, desire, erection and ejaculation are not affected because the remaining testicle is sufficient for the sexual function. Pelvic radiotherapy can lead to temporary erection disorders.

Prostate cancer: Total ablation of prostate and radiotherapy lead most of the time to impotence and medical treatments often act on testosterone secretion. A local injection of vasodilator can stimulate the erection, but only your doctor can prescribe it because of the numerous contraindications.

Hodgkin disease and lymphomas
Some chemotherapy treatments can affect male fertility, but it's becoming rarer with the new treatments.

In all cases, if you plan to have a child after your treatment, you must talk about it to your doctor, and depending on the kind of cancer and treatment, a sperm freezing could be proposed to you.

Resumption of sexual life in woman

For cancers that don't affect the female sexual zone, a "sexual fatigue" or a decrease of the desire are usual but transitory.

The situation is different for cancers affecting the sexual zone.

Breast cancer: The chemotherapy can lead to hormonal modifications, but those disorders are transitory. However, they can provoke a premature menopause.

In case of mastectomy, the psychological trauma can be very important, but a mammary reconstruction or implants can be proposed.

After the treatment, and according to the current knowledge about this subject, women treated must not take a hormonal contraception.

Uterus cancer: If you had a surgery for the treatment of any uterus cancer, there is a time of healing to respect before the resumption of your sexual life.

Pelvic radiotherapy and curietherapy lead to important hormonal disorders, often transitory.
All those interventions can provoke a physical discomfort due to the vagina size decrease. They can also provoke vagina dryness corrected by lubricants.

Hodgkin disease and lymphoma: There is no incidence on sexual life, but if you plan to have a child after the treatment by pelvic irradiation, you must have an ovarian transposition in order to protect your ovaries.

What can you do to regain your sexual function?

Knowing what sexual side effects to expect before you begin your cancer treatment can help you be more prepared to deal with them as you go through treatment. If you experience sexual side effects, find out as much as you can about what's impeding your sexual function. This will help you feel more in control and help guide you to treatment options. You may also want to:

  • Talk with your health care team: It can feel uncomfortable to talk about the sexual side effects you're experiencing. Though talking about sex can be awkward, you'll not likely find a solution if you don't let someone know what you're experiencing. Write down your questions if it makes you feel more comfortable. In addition, your doctor may be embarrassed or hesitant to talk about sex. If this is the case, ask to be referred to a specialist or seek support from other members of your health care team, such as nurses and counselors.
  • Talk with your partner: Let your partner know what you're experiencing and how he or she can help you cope. For instance, you might find that using a lubricant eases your vaginal dryness or changing positions helps you avoid genital pain during sex. Together you can find solutions to ease you back into a fulfilling sex life.
  • Explore other ways of being intimate: Intercourse isn't the only option for closeness with your partner. Consider spending more time together talking, cuddling or caressing. Connecting in other ways might help make you feel more comfortable and less anxious about the sexual side effects you're experiencing.
  • Talk with other cancer survivors: Your health care team might be able to steer you to a support group in your town. Otherwise, connect with other cancer survivors online. If you're embarrassed about discussing sex face to face with strangers, the online environment provides you anonymity. Start with the American Cancer Society's Cancer Survivors Network.

It may simply take time for you to regain your sexual function after cancer treatment. While that can be frustrating, remember that if you had a positive and satisfying sex life before cancer, you'll likely resume that after your treatment.

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