Sex and side effects of cancer treatment
Side effects of cancer treatment can affect your sex life. Not everyone will have the side effects we mention here. You may have side effects or questions we do not cover. It is also important to remember your sexual well-being and relationships can be affected by more than just these physical changes.
For each of the side effects below, we have included tips that might help, and information about where to get support. We also have information about:
- side effects that affect the female pelvis and hormones
- side effects that affect the male pelvis and hormones.
Your cancer team can answer any questions you have about your treatment. They will also tell you what to expect.
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.
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.
Some treatments can cause changes to your appearance. This can be for a short time or permanently. The changes may include:
- hair loss
- weight changes
- scars or skin changes
- lymphoedema (swelling)
- speech and mouth changes after treatment for head or neck cancer
- surgery to remove a limb or other body part.
If you find it hard to cope, give yourself time and be kind to yourself. You may find it gets easier. But if the way you feel about your appearance or body is stopping you having relationships or sex, you may want more advice and support.
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.
It can be hard to come to terms with a major body change such as having an arm or leg removed. It can affect how you feel about your body, and also how your body works.
Usually, after this type of surgery you will be fitted with an artificial arm or leg (a prosthesis). Learning to use a prosthesis takes time. You may need to experiment to find out what is comfortable for you during sex. If you have a partner, it can help to talk about how you both feel. A sex therapist may be able to help if you need advice.
It is a personal choice whether you wear your prosthesis during sex. It may help you hold a position, balance or move more easily. Or you may find sex is easier and more comfortable without it. Ask your physiotherapist or occupational therapist if you need advice about your prosthesis.
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.
Some cancer treatments, such as pelvic radiotherapy or bowel surgery, can cause:
- diarrhoea or loose poo (stools)
- needing to poo with little or no warning.
These effects may get better after treatment, but sometimes they are a long-term problem. They may make you feel embarrassed about being intimate with someone. They can also make you less interested in sex.
There are often ways to manage bowel problems. Your cancer team can give you medicines, or advice about diet changes and exercises that may help. They may arrange for you to see a specialist for treatment or more support.
These tips might help:
- For a few hours before sex, avoid eating foods that make your bowel problems worse.
- Go to the toilet just before you have sex.
- Scented candles may help if you are worried about smells.
- Make sure you can get to the toilet quickly and easily.
- Have tissues and towels nearby during sex.
- Try an anal plug. This is a foam tampon you can wear in the back passage. It may be helpful for some people who cannot control when they need to poo. Anal plugs for bowel problems are available on the NHS. Ask your cancer team or GP for 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.
The chest, breasts and nipples are sensitive areas of the body. They may be an important part of your sex life. They can also be important to how you feel about your body and sex.
Radiotherapy to the breasts or chest area can cause a skin reaction. The treated area may feel swollen, sore or tender until the skin heals. After treatment, the treated skin may permanently look or feel slightly different to before.
Surgery to the breasts or chest area can affect the nerves to parts of the chest, breast or nipple. Areas may feel numb or have less feeling than before. Sometimes this improves as you recover, but it may be permanent.
Surgery for breast cancer can also affect how the breast or chest looks. It may change the size or shape, or leave scars.
If you have a whole breast removed, you may choose to have surgery to create a new breast shape. This type of surgery is called breast reconstruction. The new breast may have less feeling or feel numb.