Effects of chemotherapy on sexuality

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Some of the side effects of chemotherapy - such as feeling sick|, weakness, depression|, tiredness| and a lack of energy - can reduce your sex drive. However, many of these side effects can be reduced or stopped with medicines.

Once chemotherapy is over, your sex drive will usually come back in time. However, if the chemotherapy has made your hair fall out|, if you’ve lost weight, or if you have a central line| or PICC line|, you may not feel very ‘sexy’. Some of the tablets given to prevent sickness can also cause a low sex drive. Once you stop taking these tablets, your sex drive should return.

Some chemotherapy drugs can affect the nerves in your hands and feet. This is called peripheral neuropathy|. It can cause tingling or numbness, or a sensation of pins and needles and pain. If your hands are uncomfortable or numb, you may find some sexual contact or positions difficult. Peripheral neuropathy is usually temporary, but may be permanent.

Effects of chemotherapy on women Back to top

In women, chemotherapy can reduce the amount of hormones produced by the ovaries. You may notice changes to your periods, which can sometimes stop altogether. Despite this change, it’s important to talk to your doctor or specialist nurse about contraception, because it’s still possible to become pregnant, even with irregular menstual cycles.

You should use a reliable barrier method of contraception all through your treatment and for up to a year afterwards.

Tiredness

Tiredness and the change in hormone levels may cause a lower sex drive, and reduce arousal during sex. Some medicines can help to increase sex drive and improve arousal. You can discuss this with your healthcare team.

Symptoms of early menopause

Because chemotherapy can reduce the amount of hormones produced by the ovaries, it can cause the symptoms of an early menopause|, including hot flushes, irritability, sleep disturbances and vaginal dryness. Vaginal thrush| is common in women having chemotherapy, especially if you’re taking steroids| or powerful antibiotics to prevent infection. Your doctor can prescribe treatment for this.

Pregnancy and chemotherapy

If you’re pregnant before your cancer is diagnosed and your chemotherapy starts, it’s very important to discuss with your doctor the pros and cons of continuing with your pregnancy. It’s sometimes possible to delay starting chemotherapy until after the baby is born. It depends on the type of cancer you have, the extent of the cancer, how advanced your pregnancy is and the particular type of chemotherapy you’ll be having.

You should talk to your doctor or nurse about your pregnancy and be sure that you’re fully aware of all the risks and alternatives before making any decisions. You can also talk to our cancer information nurse specialists|.

Effects of chemotherapy on men Back to top

Some men find that their sex drive falls while they’re having chemotherapy, due to tiredness and sometimes nausea. It will usually return to normal soon after the treatment is finished. Some types of chemotherapy reduce the amount of male hormone (testosterone) that’s produced, but this also usually goes back to normal in time.

A few chemotherapy drugs can damage the nerves (neurotoxicity), which may affect a man’s ability to get and keep an erection. Your doctor or nurse can tell you how likely this is to happen to you, based on the chemotherapy drugs you’re having. However, chemotherapy is unlikely to have any permanent effect.

Contraception during chemotherapy Back to top

Although chemotherapy can reduce fertility|, it’s quite possible for a woman having chemotherapy to become pregnant during the treatment. Female partners of a man having chemotherapy can also become pregnant.

A new pregnancy should be avoided during chemotherapy (for both men and women), as there’s a risk that the drugs could harm the developing baby. For this reason, your doctor and nurses will advise you to use a reliable method of contraception throughout your treatment and for up to a year afterwards. It’s usually best to use a barrier method of contraception (such as condoms or the cap), because the side effects of chemotherapy, such as sickness and diarrhoea|, can make the contraceptive pill less effective.

Infertility Back to top

Unfortunately some chemotherapy treatments may cause infertility (the inability to have children) in both women and men. In women, the ovaries may stop making eggs. In men, chemotherapy may reduce the number of sperm produced or affect the sperm’s ability to reach and fertilise a woman’s egg during sex. In both men and women, infertility will depend on the drugs| that are being used and may be temporary or permanent. 

It’s important to discuss the risk of infertility fully with your doctor before you start treatment. If you have a partner they will probably want to join you for this discussion. Then you can both be aware of all the facts and have a chance to talk over your feelings and the options for the future.

There are some options for dealing with infertility. We also have a separate section about cancer and fertility|.