Late effects and sex life

For some people the effects of pelvic radiotherapy on their sex life that began during treatment may not improve even after treatment has ended. Other effects on your sex life may not develop until months or years later.

Some people’s interest in sex may be reduced after treatment. Low sex drive can be caused by:

  • tiredness
  • how you feel about yourself sexually
  • men may have low testosterone.

Men may experience erection problems. The risk depends on the type of cancer, the dose of radiotherapy and any other treatments. Treatments that help with erection problems include tablets that increase the blood supply to the penis, injections and vacuum pumps.

Women may find it harder to get aroused or take longer to orgasm. This may be because of the effects of radiotherapy on the nerves in the pelvic area or it may be due to the way you feel about yourself sexually.

There are organisations that may help if you are having problems in your sex life. For example, the College of Sexual and Relationship Therapists and The Sexual Advice Association.

Long term or late effects on sex life

For some people the effects of pelvic radiotherapy on their sex life that began during treatment may not improve even after treatment has ended. Other effects on your sex life may not develop until months or years later. Some of these effects may eventually go away or improve on their own. Others can be managed or treated successfully.


Low sex drive (libido)

Some people may find that their interest in sex is reduced after treatment.

There are different reasons for this:

  • Coping with cancer and its treatment can cause anxiety, depression and low self esteem.
  • Tiredness (fatigue) may carry on for months after treatment.
  • Late bladder or bowel effects may lower your sex drive because they affect how you feel about yourself sexually.
  • Men who’ve had pelvic radiotherapy produce a lower level of testosterone, which is important for sex drive.

You may find it helpful to get emotional support or talk to a counsellor or sex therapist. As the late effects ease, you may start to feel better about yourself sexually.

Men may have a blood test to check testosterone levels, if these are low then your specialist may prescribe replacement therapy for you. Your specialist can tell you if testosterone replacement therapy is likely to be helpful for you. This may not be suitable if you have had prostate cancer.

Occasionally, doctors may prescribe testosterone for women who are distressed by their low sex drive. We normally think of testosterone as a male hormone, but women also produce it in much smaller amounts. Doctors usually only consider giving it if other approaches haven’t worked.

If you have a partner, let them know how you feel. Explaining why you don’t feel like having sex can reassure them it isn’t that you no longer find them attractive. You can show your partner how much you care in other sensual and physically affectionate ways.

If sexual difficulties don’t improve, it may be a good idea to ask for advice rather than letting things drift between you. Our section on getting help has more information.

Treating any late effects of pelvic radiotherapy that are causing you problems may improve things. For example if you don’t have much energy, having sex in different, less energetic ways or quicker sexual contact can help.


Women

Changes in sensation

After radiotherapy, some women find it harder to get aroused or take longer to orgasm. This might be because of the effects of radiotherapy, and also of surgery (if you’ve had it) on the nerves in the pelvic area. But it may be due to a difference in the way you feel about yourself sexually. A sex therapist or counsellor may be able to help you if this is the case. There are organisations that may be a source of help for you. For example, the College of Sexual and Relationship Therapists provides a Iist of qualified practitioners and The Sexual Advice Association offers a confidential helpline.


Men

Erection problems

Pelvic radiotherapy can damage nerves in the pelvic area and blood vessels that supply blood to the penis. This can cause problems in getting or keeping an erection (impotence). The risk of erection problems depends on the type of cancer you’ve had, the dose of radiotherapy you were given and any other treatments you’ve had. Your cancer specialist will discuss this with you.

Some treatments can help. These include:

  • tablets that increase the blood supply to the penis, such as sildenafil (Viagra®), vardenafil (Levitra®) or tadalafil (Cialis®)
  • pellets that are placed into the tip of the penis, called alprostadil (MUSE)
  • injections into the base of the penis, such as alprostadil or papaverine
  • vacuum pumps that are placed over the penis.

There’s some evidence that starting tablets, such as Viagra, sooner after a problem has been diagnosed is more likely to improve your ability to get and maintain an erection. Your doctor or nurse should be able to advise you on the different methods above and can refer you to a specialist if necessary. There’s more information about these treatments in our section on Sexuality and cancer. Leaflets are also available from The Sexual Advice Association.


Back to Late effects of pelvic radiotherapy

About late effects

Some people may have long term or late effects of pelvic radiotherapy. These can usually be treated or managed successfully.

Bladder changes

Late effects on the bladder can usually be managed or treated successfully. Talk to your doctor about any symptoms.

Managing bladder late effects

Read about the ways that bladder changes can be treated or managed.

Bowel changes

Late bowel effects of pelvic radiotherapy are usually managed or treated successfully. Talk to your doctor if you notice any symptoms.

Managing bowel late effects

Many bowel problems can be managed or treated successfully, with exercises, drugs and other treatments.

Coping with bowel or bladder changes

Planning ahead can make it easier to cope with the day-to-day problems caused by bladder and bowel changes.

Other late effects

Pelvic radiotherapy can also cause less common late effects.