Bowel cancer and its treatment can affect your sex life and how you think and feel about your body.
Your diagnosis, treatments and side effects may affect your sex life and how you see yourself. You may feel too tired to have sex during treatment and for a time after. This often gradually improves after treatment, but for some people it may take longer.
Changes to your body
If you have had an operation, you may have a scar or stoma. If you feel self-conscious about changes to your body, it can also affect your sexual desire. Talking about your feelings may help your anxiety. If you have a partner, you may both find it takes time to adjust to any changes.
We have more information about body image and appearance concerns.
Sometimes surgery and radiotherapy can cause problems with getting and keeping an erection (erectile dysfunction). Medicines such as sildenafil (Viagra®) can help you get an erection. If you are having erection difficulties, talk to your doctor as soon as possible. The sooner you start treatment, the more effective it is.
Women may find that changes to blood flow and nerves in the pelvic and genital area make orgasm less intense than before. It may also take longer to reach orgasm. These changes may improve over time but are sometimes permanent. Radiotherapy to the pelvic area can cause the menopause, which may lower your sex drive. Your doctor or nurse may prescribe hormone replacement therapy (HRT) to help with menopausal symptoms.
If you have had radiotherapy, you may need to be cautious with anal sex and anal play. The tissues in the area may be fragile. This can make anal sex uncomfortable. Surgery to remove the anus means anal sex and anal play are no longer possible.
Many people find it difficult to talk about sexual difficulties because they feel embarrassed or self-conscious. Your doctor or nurse will be used to talking about these issues. So it can help to talk to them if you are having problems with your sex life. They may be able to offer help and support, or refer you to a sex therapist or counsellor.
There are organisations, such as COSRT - the College of Sexual and Relationship Therapists, that can give you support. It may also help to share your experience with other people through Macmillan’s Online Community.
If you identify as LGBT+
If you identify as LGBT+, you may worry about being treated insensitively by your healthcare team. You may have some specific questions. Having your sexual or gender identity acknowledged can help you feel more supported. It also means your healthcare team can give you the right information and advice.
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.
Treatments for bowel cancer can affect your ability to start a pregnancy (fertility). This can be difficult to cope with, even if you have a family or did not plan to have children. It is important to tell your healthcare team any concerns you have about your fertility before treatment starts. They can tell you what options might be available if you would like to have a child in the future.
Below is a sample of the sources used in our bowel cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
R Glynne-Jones, PJ Nilson, C Aschele et al. ESMO-ESSO-ESTRO Clinical practice guidelines for diagnosis, treatment and follow up for anal cancer. July 2014. European Society of Medical Oncology. Available from www.esmo.org/Guidelines/Gastrointestinal-Cancers/Anal-Cancer (accessed October 2019).
National Institute for Health and Excellence (NICE). Colorectal cancer: diagnosis and management clinical guidelines. Updated December 2014. Available from www.nice.org.uk/guidance/cg131 (accessed October 2019).
Association of Coloproctology of Great Britain & Ireland (ACPGBI). Volume 19. Issue S1. Guidelines for the management of cancer of the colon, rectum and anus. 2017. Available from www.onlinelibrary.wiley.com/toc/14631318/19/S1 (accessed October 2019).
BMJ. Best practice colorectal cancer. Updated 2018. Available from www.bestpractice.bmj.com/topics/en-gb/258 (accessed October 2019).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.
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