How chemotherapy may affect your sex life and fertility
Having chemotherapy can affect your sex life, although not everyone finds this. Side effects like tiredness, feeling sick or weak can reduce your sex drive and make having sex difficult.
Chemotherapy shouldn’t have a long-term effect on your sex life. The side effects will usually gradually wear off when your treatment is finished.
Feeling low or anxious can also affect your sex life. The anxiety may not be about sex. You might have worries about the cancer, how your family is coping or about money.
We have more information in our section on sexuality and cancer.
Usually there’s no medical reason to stop having sex during chemotherapy. But if you have low platelets, or a low white blood cell count, you may be advised to avoid penetrative sex until your blood count improves.
It’s not easy to talk about sex, but it can help to talk through any concerns about your sex life with your doctor or specialist nurse. They can often reassure you and support you with any problems.
It’s also important to talk about how you feel with your partner. Cuddling, touching and stroking are good ways of showing your feelings even if you don’t feel like having sex.
We have information that you might find helpful in our section about cancer, you, and your partner.
Protecting your partner
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It’s not known if chemotherapy drugs pass into semen or vaginal fluids. Doctors usually advise you to use condoms for a few days after chemotherapy to protect your partner.
Remember that cancer can’t be passed on to your partner and sex won’t make the cancer worse.
It’s important to use effective contraception during chemotherapy to avoid a pregnancy as the drugs might harm a developing baby. Your doctor or nurse will advise you to use reliable contraception during chemotherapy and for a few months afterwards.
It’s usually best to use ‘barrier’ methods such as condoms, the cap or the coil (non-hormonal if you have breast cancer). Chemotherapy side effects, such as sickness and diarrhoea, can make the contraceptive pill less effective. If you’re taking it you need to check with your cancer doctor if it’s okay to continue using it.
In some women, chemotherapy causes an early menopause. This can cause menopausal symptoms like hot flushes, vaginal dryness, anxiety, mood swings and a reduced sex drive (libido). Your periods will stop and you’ll start the menopause. Doctors usually say early menopause is before 45.
You may be able to have hormone replacement therapy (HRT) to replace the hormones your ovaries are no longer producing. It can improve some symptoms of the menopause and protect your bones and heart. Early menopause can increase the risk of bone thinning (osteoporosis).
But some cancers, for example breast cancer and womb cancer, depend on hormones to grow so your specialist may not advise HRT. We have a fact sheet about managing menopausal symptoms for women with breast cancer.
If you’ve had early menopause because of chemotherapy, ask your cancer specialist if HRT is suitable for you.
Managing menopausal symptoms
If HRT isn’t advised or if you don’t want to take it, there are different ways that symptoms can be managed. If your symptoms are affecting your day-to-day life, ask your doctor about other medicines that may help with menopausal symptoms.
Low doses of antidepressant drugs, or a drug called Clonidine (Catapres®, Dixarit®) used to control blood pressure, can reduce hot flushes and sweats. Some women find that using a slow, controlled breathing technique, yoga or acupuncture may help with flushes. Different lubricants or creams can be used to help reduce discomfort from vaginal dryness during sex.
The Daisy Network is a support organisation for women who have early menopause. You can also contact our cancer support specialists if you’d like more information.
Diane talks about how she coped with an early menopause after her treatment for breast cancer.
Unfortunately, some chemotherapy drugs can cause infertility (inability to become pregnant or to father a child).
It’s important to discuss your infertility risk with your cancer doctor before you start chemotherapy. If you have a partner, it’s a good idea to include them in this discussion.
Although chemotherapy can affect fertility, it’s still possible for a woman to get pregnant or for a man to get his partner pregnant during chemotherapy. It’s important to avoid pregnancy when you’re having chemotherapy as the drugs could harm a developing baby.
Some, but not all, chemotherapy drugs may temporarily or permanently stop your ovaries producing eggs.
Chemotherapy may cause your periods to become irregular or stop for a while (temporary infertility). But after treatment stops, the ovaries can start producing eggs again and your periods will return to normal. It may take a few months or up to two years for your periods to come back. The younger you are, the more likely you are to have periods again and still be fertile after chemotherapy.
If your periods don’t come back you won’t be able to become pregnant and will have your menopause.
It’s important to know if your fertility is likely to be affected before chemotherapy starts. You can then decide if you want to be referred to a fertility specialist. They can discuss possible options to help preserve your fertility, such as storing embryos (fertilised eggs) or eggs, with you.
We have a section on cancer treatment and fertility for women, which has more information.
Some chemotherapy drugs have no effect on fertility, but others can slow down or stop you producing sperm. For most men this will be temporary. Any problems with sperm production won’t stop you from getting an erection or enjoying sex.
Even if your chances of becoming infertile are low, you may still be advised to store sperm for use in the future. This has to be done before you start chemotherapy. Teenage boys at risk of infertility should also, if possible, have their sperm stored for later years.
You’ll usually be asked to produce several sperm samples over one or two weeks. These will be frozen and stored so they can be used later to try to fertilise an egg and make your partner pregnant.
It can take a few years for your sperm count to go back to normal after chemotherapy. Unfortunately in some men infertility is permanent. Your doctor can check your sperm count after treatment is over.
There’s more detailed information in our section on cancer treatment and fertility for men.
Feelings about infertility
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If you had been planning to have children in the future or to have more children, infertility can be very hard to come to terms with.
You may find it helpful to talk about your feelings with a trained counsellor or therapist specialised in fertility problems. Your doctor or specialist nurse may be able to arrange this. Our cancer support specialists on freephone 0808 808 00 00 can also provide support.
Pregnancy and chemotherapy
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It isn’t a common situation to be pregnant and need chemotherapy. But if you are, or discover you’re pregnant during chemotherapy, you and your partner will need careful discussions with your doctor.
Your cancer doctor will advise you about any possible risks to the baby (from chemotherapy) and how being pregnant may affect your cancer treatment plan.
It is sometimes possible to delay chemotherapy until after a baby is born, or to give it later in the pregnancy.
This will depend on the type of cancer you have, it’s stage, the chemotherapy drugs you need, and how many months pregnant you are. Your cancer doctor will explain if these are options in your situation.
This can be a difficult and distressing time, especially if it involves making decisions about continuing with the pregnancy. You’ll need time to take in the information you’ve been given, and to talk it over with your partner and family. Your specialist nurse and your cancer doctor are also there to help support you. If you need more specialised support they can refer you to a counsellor. You can also talk to our cancer support specialists.
Breastfeeding and chemotherapy
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Breastfeeding during chemotherapy is not advised as the drugs could be passed on to a baby through breast milk. If you want to give your baby breast milk during chemotherapy, you may be able to express extra milk before treatment starts and freeze it.
You may be able to express milk, which you cannot keep or use, throughout your chemotherapy so that you’re still producing milk when chemotherapy finishes. You may then be able to start breastfeeding after chemotherapy. But this will depend on whether you’re having any other treatment that could interfere with breastfeeding.
Your cancer doctor and specialist nurse will advise you if this is possible and if so when it’s safe to start. Having chemotherapy won’t affect your ability to produce breast milk in the future.