You probably have many questions about the disease’s impact and treatment on your lifestyle during cancer treatment. However, one of the last things you might think to ask about is how your treatment — and the resulting side effects — could affect your sexuality. You might not feel comfortable discussing the topic of sex, or it may be the furthest thing from your mind right as you grapple with all the other elements of your cancer treatment. But you should know that even if you are not currently sexually active, it’s very typical to have questions and concerns about sex and fertility during and after cancer treatment.
A LIVESTRONG poll concluded that nearly 60% of cancer survivors report experiencing sexual dysfunction after treatment. As many as 85% to 90% of prostate cancer, breast cancer, and gynecologic cancer survivors report long-term concerns regarding physical intimacy.
When is it OK to have sex during cancer treatment?
Physicians suggest that patients wait for at least 48 to 72 hours after receiving chemotherapy to have sex (vaginal, oral, or anal). This is the average amount of time it takes the chemo to leave the system. Always talk with your medical team about your particular chemotherapy and their recommendations regarding intercourse.
There are different types of radiation, so talk with your radiation oncologist about the type of radiation you are receiving and the length of time you need to wait before having sex.
If surgery is part of your treatment plan, talk with your surgeon about when it will be safe to have sex again, so you can avoid causing pain or slow healing at the surgery site.
Common Emotional Concerns Regarding Sex after a Cancer Diagnosis
Post-cancer sexual concerns can be both mental and physical. Emotionally, both partners may feel nervous about having sex after one of them has had a severe disease, such as cancer. Your partner may be worried about emotionally pressuring or causing physical pain to you.
The patient may feel nervous about how their partner will respond to changes in their physical appearance. Body image issues can occur after cancer treatment.
Both partners also may worry about having a lowered sex drive and question whether they’ll be able to achieve orgasm. Many couples experience an adjustment period as they transition away from what may have become a patient/caregiver relationship back to the romantic partner relationship they enjoyed before the cancer diagnosis.
Issues that could affect intimacy during and after cancer treatment
Patients receiving radiation or chemotherapy for cancer may experience side effects that impact sexuality and intimacy. Some of those side effects are dependent on the type of cancer and can linger after treatment is over. However, many of these symptoms will go away over time.
Common symptoms of sexual dysfunction by cancer type include:
- Breast cancer patients who had a mastectomy may experience loss of sensation, fatigue, and symptoms related to reconstructive surgery – such as feeling discomfort while getting used to new breast implants.
- Lumpectomy patients may experience decreased sensation in their breasts and nipples, along with lymphedema.
- Patients who receive chemotherapy, radiation, or hormone therapy may experience menopausal symptoms, fatigue, increased scarring, and lymphedema. (Menopausal symptoms can include decreased sex-drive or libido, vaginal dryness, vaginal atrophy, and mood swings.)
- Colorectal cancer patients who receive surgery or radiation may experience bowel/bladder changes and complications associated with ostomies/stomas.
- Prostate cancer patients who receive surgery may experience a lowered libido erectile dysfunction, difficulty climaxing, or dry orgasm.
- Patients who receive hormone treatments may experience lowered libido, hot flashes, erectile dysfunction, or gynecomastia (growth of breast tissue.)
Gynecologic Cancers: Including Cervical, Endometrial, or Ovarian Cancer
- Patients who receive a hysterectomy for gynecologic cancer may experience loss of sensation, menopausal symptoms, fatigue, lymphedema in lower extremities, or prolapse. (Prolapse is when the bladder, vagina, uterus, or surrounding structures begin to fall out of their normal positions.)
- Chemotherapy or radiation may cause patients to experience low libido, menopausal symptoms, fatigue, increased scarring, bowel and bladder issues.
Other Symptoms of Sexual Dysfunction in Patients
- Numbness at the surgical site
- Neuropathy (nerve pain)
- Nausea caused by chemotherapy
- Altered body image (permanently or temporarily)
- Anxiety or depression from a fear of recurrence
Strategies for Improving Sexual Desire and Function
Everyone’s physical symptoms, intimate relationships, and emotions are different. There are no standard rules for improving your sex life after cancer. But the following are suggestions to consider:
- If you are a woman experiencing vaginal dryness:
- ask your doctor if estrogen can help in easing your symptoms.
- use lubricants during intercourse for short-term relief.
- use vaginal moisturizers daily for long-term relief.
- Consider therapy or medication if you are experiencing anxiety or depression.
- Exercise (discuss with your doctor before beginning a new exercise plan.)
- Focus on getting more/better sleep.
- Experiment with different sexual positions or aids, such as vibrators.
- Practice kegel exercises to strengthen pelvic muscles.
- Work on improving your self-acceptance and self-confidence (your partner found you attractive before cancer and may find you even more beautiful after you have conquered cancer!)
- Work on relaxing.
Communication is Key
As it was before a cancer diagnosis, the key to a healthy and fulfilling sex life after cancer is communicating with your partner. Sharing your anxieties and fears with your partner can be the first step toward restoring a mutually satisfying sex life.
Discussing issues is healthy and opens up a channel to resolve those issues. Often, couples discover that their biggest fears were all in their head.
Often, beginning a dialogue about intimacy can be challenging. Individual or couples counseling is often beneficial. Be open and honest with your cancer care team about the anxiety you’re experiencing surrounding your sex life. They may be able to recommend therapists or tools and techniques to improve your libido and sexual function.
At Rocky Mountain Cancer Centers, your health care team is here to talk with you about anything that affects your health and well-being — including sex. As with any questions you have during treatment, be sure to speak with your oncologist and other cancer care providers about your specific circumstances.