Cancer and cancer treatment can affect many areas of sexual well-being.
They may cause changes that are:
- physical – you may have side effects or symptoms that change how your body works or looks
- emotional – you may be dealing with stress, worry or other difficult feelings
- practical – your usual routines or roles may change.
These areas are often linked. If there is a change in one area, it may affect another. Many changes caused by cancer treatment are temporary and usually get better after treatment. As you recover, you may find your sex life goes back to the way it was. Sometimes people might have to adjust to changes that last longer or that may be permanent.
There can be ways to improve your sexual well-being and to manage any problems. But sometimes this gets forgotten because there are other things to cope with when you have cancer. It may also be ignored because you or your healthcare team feel embarrassed or worried when talking about sex.
Some people worry about whether it is safe to have sex after being diagnosed with cancer. It is important to remember that sexual touching, penetration or close physical contact:
- cannot pass cancer on to a partner
- will not affect the cancer
- does not make cancer more likely to come back.
If you feel like having sex then it is usually safe to do so. And some people find they enjoy sex and want to keep their sex life as normal as possible. Your cancer doctor or nurse will tell you if you need to make changes to your sex life because of a treatment.
- You may have had surgery or radiotherapy to the pelvic area – Your body may need time to heal properly before you receive vaginal or anal sex.
- You may have had certain types of internal radiotherapy called seed brachytherapy or radioisotope therapy – You may be advised to avoid close physical contact for a short time. This is to protect partners from radiation.
- You may have had high-dose chemotherapy or a stem cell transplant – You will be advised not to have close physical contact with anyone for a while. This is to protect you from infection. Your cancer doctor or specialist nurse will explain more about this.
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If your sexual well-being is affected before, during or after cancer treatment, this does not mean your sex life is over. There may be advice, support or treatments that can help.
Talk to your GP, cancer doctor or specialist nurse or your local sexual health service. They may offer advice or treatments that can help you. Or they may suggest that you see someone else if you need more help.
Sometimes it helps to talk about sexual problems. Your healthcare team may arrange for you to talk to a counsellor, psychologist, psychiatrist or sex therapist. These professionals all work in slightly different ways. But they can all help you understand and cope with your feelings or any changes.
You can often get support with sexual problems through the NHS. But some services, such as seeing a sexual therapist may only available privately or through another organisation. Your healthcare team can explain what is available in your area. The College of Sexual and Relationship Therapists have a list of professional therapists on their website.
Talking about sex with your healthcare team
It can be difficult to start a conversation about sex with someone from your healthcare team. Some people feel embarrassed or uncomfortable talking about something so personal. But it is important to get the right information when you need it. You can ask your healthcare team about anything before, during or after cancer treatment.
A health professional may not ask about your sexual well-being unless they know you want to talk about it. Tell them if you have questions or are worried about anything. They will understand that these questions are important to you. Even if you feel embarrassed, you should still ask for information and support. Most health professionals are used to having these conversations.
Tips for talking
You may find it helpful to prepare before you talk to a health professional. Here are some tips:
- Think about who you want to talk to. Is there someone in your healthcare team you feel more comfortable with?
- Think about what information you want. For example, you may want to know why you have lost interest in sex since starting treatment. Will this improve? What might help?
- Write down the questions you want to ask.
- Practice what you want to say.
- At the start of your appointment, tell the health professional you would like some time to ask questions.
- Do not worry about using the right medical words about sex or your body. Use the words you understand.
- If something is not clear, ask the health professional to explain again.
Your healthcare team are there to support you and treat you in a way you feel comfortable with. There may be times when it helps them to know how you identify your gender or sexual orientation. It may help you feel better supported. And your healthcare team can give the right information and support to you and your partner if you have one.
The impact of cancer and cancer treatment are often the same whatever your sexual orientation or gender. But you may have some specific questions about how these will affect your sexual well-being. The NHS aims to provide healthcare to everyone. This includes providing care and support about sexual well-being to people of all genders and sexual orientations.
If your healthcare team cannot help, they can refer you to a sex therapist or another specialist who can. If you want to talk things through, you can call the LGBT Foundation on 03453 30 30 30. They can give you confidential advice and support.
If you are trans or non-binary
If you are trans or non-binary, talking to a health professional about sex can sometimes be especially difficult and complicated.
Some of the information you need may involve parts of the body that do not reflect your gender identity. You may find this uncomfortable or upsetting to talk about. You may also have specific questions about sex and cancer if you take hormones or have had gender realignment surgeries.
If you do not feel you can talk to your healthcare team, you could talk to:
- your local sexual health service
- a transgender sexual health service
- the LGBT Foundation.
Some cancer treatments may directly change how the body works sexually. This may include:
- surgery or radiotherapy to the pelvic area (the area below your tummy and between your hips)
- hormone therapy – this is often used to treat breast or prostate cancer
- chemotherapy if this causes an early menopause
- surgery or radiotherapy to the pituitary gland or brain.
Other treatments cause general side effects that can change how you feel about your body or about having sex. For example, treatment might cause tiredness (fatigue) or pain, or make you feel sick. This may mean you are less interested in sex. Or if your body or appearance changes in some way, this can affect how you feel about your body and sex.
We have more information about:
- side effects that affect the female pelvis and hormones
- side effects that affect the male pelvis and hormones
- side effects that affect other areas of the body.
You may also find our information about the body and sex helpful.
Your thoughts and feelings have a powerful effect on your sexual well-being. Being diagnosed with cancer can cause strong emotions.
How you feel about yourself sexually may also change if you:
- are feeling less in control
- feel weak or tired
- feel your role has changed at home or work
- have changes to how your body looks or works.
Whatever feelings you have, it can help to talk to someone. You may not need advice. It is often helpful to have someone just listen.
Try to find someone that you trust and feel comfortable talking to. This could be a partner, a family member, a friend or a professional (GP, cancer doctor or specialist nurse).
Talking to someone who has been through a similar treatment or situation can also help. Sometimes your cancer doctor or specialist nurse can arrange for you to talk to someone like this. Or you could join a cancer support group, or our Online Community.
Some support groups are for anyone affected by cancer or a type of cancer. Some are for anyone of a specific gender or sexual orientation. Some groups meet face to face and others meet online.
You may prefer to get support from a helpline or through email or webchat. These can be anonymous, and it might feel easier to talk about sex and ask questions this way.
Some cancer treatments can be harmful to an unborn baby. During your treatment and for a time after, it is important to use contraception if you or a partner could become pregnant.
Even if your cancer treatment is likely to damage your fertility, you may still be able to start a pregnancy. Your cancer doctor or specialist nurse can tell you more about this.
There are many different types of contraception. Ask your cancer doctor or specialist nurse which type is best for you to use. This will depend on you and the type of cancer treatment you are having. Condoms or caps (diaphragms) can be used whatever type of cancer treatment you have.
Some hormonal contraceptives (such as the pill, patch, injection or implants) may not work during cancer treatment. This can be because of:
Your doctor or nurse can tell you more about what types of contraception are safe for you to use.
Small amounts of chemotherapy, or other drugs, can get into your body fluids. This includes fluid made in the vagina and the fluid that contains sperm. To protect any partners, your cancer doctor may advise that for a few days after certain drugs you use:
- a condom for vaginal or anal sex
- a condom (or a latex barrier such as a dental dam) for oral sex.
Your cancer doctor or specialist nurse can give you more information about your treatment. If you use a lubricant, only use a silicon or water-based product with condoms or dental dams.
Using condoms and dental dams also helps protect you from sexually transmitted infections (STIs). This is especially important if your cancer treatment affects how your body fights infections. Again, if you use a lubricant, only use a silicon or water-based product with condoms or dental dams.
You should also:
- Avoid giving oral sex if you have cuts or sores in your mouth. There is a risk these could become infected.
- Tell your doctor if you notice any bleeding after sex. If the bleeding does not stop, contact a hospital straight away.
- Use a condom and some silicon or water-based lubricant if you give or receive anal sex. This helps prevent bleeding or infection.
- Never use the same condom for anal then vaginal or oral sex.
- Clean sex toys, dildos or other objects before you use them, or cover them with a condom. If you use one for anal sex, clean it or change the condom before you use it for vaginal sex. If a partner uses it too, clean it or change the condom before you use it again.
Lubricants are gels or liquids that you can use before or during sex. Using lubricant can make penetration or sexual touching feel good. It can also make it feel easier and more comfortable.
Lubricants can be oil, silicon or water-based. Always check the instructions to find out what type you are using. You should only use a silicon or water-based lubricant with a condom, dental dam, latex cap (diaphragm) and latex sex toys. Oil-based lubricant can make condoms, dental dams and latex caps tear and stop them working.
There are many brands of lubricant. Some products are available on the NHS. You can also buy lubricants from a pharmacy or other shop, or online.