Sex life during pelvic radiotherapy

Your cancer doctor or specialist nurse may advise you to wait until a few weeks after treatment has ended before having sex to allow side effects to settle.

Some people don’t feel like having sex for a while after treatment and you may need some time to adjust. When you feel ready it’s safe for you and your partner to have sex following this type of treatment.

Men who’ve had treatment with radioactive seeds in the prostate gland should use condoms for the first few weeks after treatment to protect their partner. Pelvic radiotherapy may also cause changes to ejaculation in men.

Women may experience dryness in the vagina which makes sex uncomfortable. This can be eased using creams and lubricants.

Both men and women who have had pelvic radiotherapy should use effective contraception. This is because radiation may cause damage to a baby that is conceived during or shortly after radiotherapy.

If you are having sexual difficulties that don’t improve talk to your cancer doctor or specialist nurse. It may feel embarrassing but they are used to dealing with intimate problems.

Having sex during treatment

You may be advised to wait a few weeks until after radiotherapy before having sex. This is to allow any inflammation and side effects to settle. Ask your doctor or nurse for advice on this, as it can vary.

You may find that you don’t feel like having sex for a while. This may be because of ongoing side effects, anxiety, or how you feel about yourself sexually. You, and your partner if you have one, may need a period of time to adjust. It’s not unusual to feel nervous about having sex for the first time after pelvic radiotherapy, but it’s perfectly safe for both you and your partner.

If you have sexual difficulties that don’t improve, it’s important to let your cancer doctor and specialist nurse know. It can be difficult to talk about your sex life and any problems you’re having, but doctors and specialist nurses are used to dealing with intimate problems. They can often give you advice and support if things aren’t going well. Your hospital doctor or GP can refer you to a counsellor or sex therapist.


Men

Protecting your partner

If you’ve had brachytherapy (radioactive seeds placed in the prostate gland) it’s advisable to use condoms during sex for the first few weeks after treatment. This is in case a radioactive seed moves from the prostate into the semen. However, it’s very rare for this to happen.

Contraception

It’s fine to have sex during radiotherapy if you want to. However, sperm produced during and for some time after treatment may still be fertile but damaged. This could cause abnormalities in a child conceived soon after pelvic radiotherapy. To prevent this, your doctors may recommend that you use contraception during and for six months or more after treatment.

Changes in ejaculation

Some men may have a sharp pain when they ejaculate. This is because radiotherapy can irritate the tube that runs through the penis from the bladder (the urethra). The pain should ease off a few weeks after treatment finishes.

After pelvic radiotherapy, the amount of semen you produce is reduced. This means that, when you ejaculate, you may notice that only a small amount of fluid comes out. Some men don’t produce any semen at all, and this is known as a dry ejaculation. Although you will still be able to orgasm (climax), some men find the sensation feels different from before.


Women

Vaginal dryness

This can make having sex uncomfortable, but there are lots of vaginal lubricants and creams that can help. You can buy them from chemists and some supermarkets. Hormone creams can also be used to help with dryness and vaginal narrowing. If you have a cancer that’s dependent on hormones to grow, always check with your cancer specialist whether hormone creams are suitable for you. These are available on prescription from your doctor.

Contraception

Some hospitals may advise that you can still have penetrative sex during radiotherapy. Although pelvic radiotherapy will bring on the menopause, your periods may not stop completely until after treatment is over. If you’re having sex during treatment, it’s very important to use effective contraception to prevent pregnancy until your periods stop completely. This is because radiation may cause damage to a baby that is conceived during or shortly after radiotherapy.

If you have problems with your bowels, such as loose stools or diarrhoea, you should use a barrier form of contraception instead of the contraceptive pill. This is because diarrhoea can affect the way that the contraceptive pill is absorbed.

You should always talk to your specialist nurse or doctor before you stop using contraception.


Long term or late effects on sex life

For some people the effects of pelvic radiotherapy on their sex life may not improve even after treatment has ended. Some people may find that their interest in sex is reduced after treatment. We have more information on low sex drive as well as erection problems in men and changes in sensation in women.

Back to Pelvic radiotherapy explained

About pelvic radiotherapy

Pelvic radiotherapy can be used to treat cancers of the bladder, rectum, anus, prostate, vulva, vagina, womb or cervix.

The pelvis

Information on the pelvic area of the body.

Side effects during treatment

You may have side effects during and shortly after your treatment. The healthcare team will help you to manage these.

Fertility and pelvic radiotherapy

Pelvic radiotherapy can affect your fertility. This can be distressing but getting the right support can help you to find ways of coping.