Effects on sex life and fertility

Chemotherapy and its side effects can affect your sex life and fertility. It can help to talk through any concerns with your doctor or specialist nurse. It’s also important to try to talk about how you feel with your partner.

Some chemotherapy drugs can affect fertility. This may be temporary or permanent. It’s important to discuss your risk of infertility with your cancer doctor before you start chemotherapy. They can advise you on the options you may have. If you have a partner, you could include them in this discussion.

It is still possible for a woman to get pregnant or for a man to get his partner pregnant during chemotherapy. It’s important to use contraception during treatment and for a few months after. This is to avoid pregnancy as the drugs could harm a developing baby. Breastfeeding during chemotherapy treatment is also not advised.

Doctors will also advise you to use condoms for a few days after chemotherapy to protect your partner in case there is any chemotherapy in semen or vaginal fluid.

Effects on sex life

Having chemotherapy can affect your sex life, although not everyone finds this. Side effects like tiredness, or feeling sick or weak can reduce your sex drive and make having sex difficult. Feeling low or anxious can also affect your sex life. You might have worries about the cancer, how your family is coping or about money.

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, your doctor may advise you to avoid penetrative sex until your blood count improves.

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 try 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.

Chemotherapy shouldn’t have a long-term effect on your sex life. The side effects usually gradually wear off after your treatment finishes.


Effects on fertility

Unfortunately, some chemotherapy drugs can cause infertility. Infertility is the inability to become pregnant or to father a child. This may be temporary or permanent, depending on the treatment that you have.

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 at 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.


Women

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 them to come back again. 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.


Men

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.


Feelings about infertility

If you had been planning to have 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 who specialises in fertility problems. Your doctor or specialist nurse may be able to arrange. Our cancer support specialists on freephone 0808 808 00 00 can also provide support.


Contraception

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 use effective contraception during chemotherapy and for a few months afterwards to avoid a pregnancy. This is because the chemotherapy drugs could harm a developing baby. Your cancer doctor or nurse can give you more advice.

It’s usually best to use ‘barrier’ methods of contraception during treatment. For example, condoms or the cap. Side effects from chemotherapy, such as sickness and diarrhoea, can make the contraceptive pill less effective.


Protecting your partner

If you have sex in the first couple of days of having chemotherapy, you need to use a condom. This is to protect your partner in case there is any chemotherapy in semen or vaginal fluid.

Cancer cannot be passed on to your partner and sex won’t make the cancer worse.


Pregnancy and chemotherapy

If you know you are pregnant before starting treatment or become pregnant during treatment, let your cancer doctor or nurse know straight away. They will talk things over carefully with you and your partner. They will explain the possible risks and benefits of having chemotherapy during pregnancy.

It is sometimes possible to delay chemotherapy until after a baby is born, or to have treatment later in the pregnancy. This depends on the type of cancer, its stage, the drugs you need, and how many months pregnant you are. Your cancer doctor and nurse will explain the different options in your situation.

This can be a difficult and distressing time, especially if you need to make decisions about continuing with the pregnancy. You will need time to think about the information you have been given and to talk about it with your partner and family. Your cancer team will help to support you. If you need more specialised help, they can refer you to a counsellor. You can also talk to our cancer support specialists on 0808 808 00 00.


Breastfeeding and chemotherapy

Breastfeeding during chemotherapy is not advised. This is because the drugs could be passed to your baby through breast milk. You may be able to express extra milk before chemotherapy starts and freeze it to use later.

During chemotherapy, you may be able to express milk, which you cannot keep or use, so that you are still producing milk when your treatment finishes. You may be able to start breastfeeding after chemotherapy. But this will depend on whether you are having any other treatment that could interfere with breastfeeding. Your cancer doctor and nurse will tell you about this.

Having chemotherapy will not affect your ability to breastfeed in the future.


Early menopause

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 HRT to replace the hormones your ovaries are no longer producing. It can improve some symptoms of menopause and protect your bones and heart. Early menopause can increase the risk of bone thinning.

But some cancers, for example breast cancer and womb cancer, depend on hormones to grow so your specialist may not advise HRT. We have more information 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.

Breast cancer and the menopause

Diane describes living with breast cancer and the menopausal symptoms that were caused by her chemotherapy.

About our cancer information videos

Breast cancer and the menopause

Diane describes living with breast cancer and the menopausal symptoms that were caused by her chemotherapy.

About our cancer information videos


Managing menopausal symptoms

If your doctor doesn’t advise you to take HRT 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 anti-depressant drugs, or a drug called Clonidine (Catapres®, Dixarit®) which is 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 help reduce discomfort from vaginal dryness during sex.

Back to Side effects of chemotherapy

Possible side effects

There are many possible side effects to chemotherapy treatment, but they can be reduced. There are practical ways to manage them.

Chemo brain

Chemo brain describes changes in memory, concentration and the ability to think clearly. These changes can sometimes happen during or after cancer treatment.

Possible effects on fertility

Chemotherapy can affect your fertility. If this is a concern for you, it’s very important to discuss it with your doctor before treatment.