Sex and side effects of cancer treatment

Most people will have some general side effects. These usually get better, but they can affect your sexual well-being for a while.

During and after treatment, you might have less energy, need more rest or get tired easily. When you are tired, you may be less interested in sex or even in spending time with other people.

If you are with a partner, it might help to just spend time being close and intimate without having sex. Sometimes this can lead to sex. But it is also a way to build trust and confidence together.

If you want to have sex or masturbate, choose a comfortable and relaxed position. You may want to plan for a time of day when you have more energy. Do not put pressure on yourself to make it last a long time or to orgasm.

We have more information about tiredness.

Some cancer treatments can cause sickness and nausea. These treatments include chemotherapy and some types of radiotherapy. Your cancer team will give you drugs to prevent sickness. Tell them if you still feel sick, so they can help.

Your treatment may only make you feel sick at certain times. For example, chemotherapy is most likely to make you feel sick in the hours or days after you have it. If you can work out a pattern, plan for times when you are likely to feel more interested in sex.

We have more information on sickness and nausea.

Any type of pain can make you feel less interested in sex. You might not want to have sex because you feel uncomfortable. Or you might be worried that sex or masturbation will be painful.

It can help to experiment. You may want to do this with a partner or by yourself first. Find out which positions or types of touching feel comfortable for you.

If you have a partner, it can help to talk about how you are feeling. They may not want to have sex if they are worried about hurting you. Try to find a position that feels comfortable and relaxed for you both.

If you have pain in the pelvic area, you may want to try types of sexual contact that do not involve penetration. If you want to have vaginal or anal sex, using lubricant may make things more comfortable. Or you can choose positions that allow you to control the depth and speed of penetration.

You can also ask your cancer team or GP for advice about painkillers and ways to reduce the pain.

Lymphoedema is swelling caused by a build-up of fluid in the body’s tissues. Sometimes this is caused by cancer or treatments such as surgery or radiotherapy. Depending on the type of cancer, the swelling may affect:

• an arm or leg
• a breast
• an area of the head or neck
• an area of the pelvis, such as the vulva or penis and testicles.

This may affect your sex life or how you feel about your body. If you want to have sex, it may help to:

• try positions that do not put weight on the affected area
• have sex at times when the swelling is less – this might be in the morning, or after you have worn a compression garment for a few hours
• use lots of lubricant to protect the skin if the vulva or penis and testicles are swollen.

You can get advice about lymphoedema from your cancer team, GP or lymphoedema specialist.

We have more information about lymphoedema.

Surgery or radiotherapy to the face, mouth or neck may change:

• how you move your mouth and jaw
• the feeling in these areas
• your saliva (spit)
• how you swallow.

Most difficulties will improve as you recover after treatment. Some may take longer or be permanent. They may affect how you feel about being intimate with a partner.

Give yourself time to adjust to any changes. Changes such as a dry mouth can often be improved, but you may need to try different things to find what helps.

If you are not comfortable with kissing or using your mouth during sex, tell your partner. There are other ways to give and receive pleasure. A sex therapist may be able to help if you need advice.

Sometimes surgery to the bowel or for bladder cancer involves making an opening through the tummy wall. This is called a stoma. It allows either pee (urine) or poo (stools) to drain from the body into a bag that covers the stoma.

Having a stoma can affect your confidence and the way you feel about your body. Sex will not harm the stoma, but it can make some positions uncomfortable. Choose positions that keep weight off it. You should not use the stoma opening for penetrative sex.

These tips might help:

• Make sure the stoma bag fits well and does not leak.
• Empty the bag before sex.
• You may want to wear clothing that covers or supports the bag to keep it secure.
• You may be able to plug the stoma or wash it out, so a bag is not needed for a short time. Ask your stoma nurse, cancer team or GP for advice.
• Remember your stoma is likely to be most active in the 2 hours after eating. Some foods can make the bag fill quickly. Avoid eating or drinking anything that usually causes you problems.

You can also find more information about sex and stomas from the Ileostomy and Internal Pouch Support Group or the Sexual Advice Association.