Coping with other physical effects on a woman’s sex life

Cancer and its treatment can have different effects on your body.

These can include things such as having pain or being very tired. Or having surgery such as having had a breast removed or a stoma made. Or you may have side effects from treatment for example urinary problems or bowel problems. All of these things can affect your sexual desire, your confidence or your physical sex life.

There are different things you can do to help, depending on what the problem is. For example, if you are very tired you can chose to have sex when you have more energy. If you have pain, try having sex after taking painkillers. You may also find it helpful to try different positions. If you have a stoma, choose a position to keep the weight off the stoma. Emptying the bag before having sex will also help.

Pain

Pain can reduce sexual feelings and desire. If you have pain or are worried about pain, it may be helpful to:

  • have sex after taking painkillers and wait a short time for them to work
  • learn some relaxation techniques to use before having sex
  • take control of the depth and speed of penetration
  • try to ensure you and/or your partner are close to orgasm before penetration
  • try types of sexual contact that you don’t find painful, such as sexual contact without penetration
  • use pillows and cushions to help you feel more comfortable and supported
  • have sex side by side, to reduce body weight on a sore area.

We have more information about controlling cancer pain that might help.


Tiredness

You may feel tired for weeks or months after treatment. This may affect your sexual desire. If you don’t feel like having sex because of tiredness, talk to your doctor. They can check if there is anything causing your tiredness that could improve with treatment. If you feel tired but would like to have sex, you may want to try:

  • having sex in the morning, or when you have the most energy
  • experimenting with less demanding sexual positions
  • making sure you and/or your partner are close to orgasm before penetration.


Surgery to remove part or all of a breast

The breasts and nipples are often sources of sexual pleasure for women and their partners. For many women, they are also linked to feelings of femininity and sexual attractiveness.

After having breast surgery, you may have areas of numbness or decreased sensation in the breast and nipple.

If you have a breast removed, you may choose to have surgery to create a new breast shape. This is called breast reconstruction. It may be done at the same time as the breast is removed, or a few months later. A reconstructed breast may feel numb.

It might help to explore different erogenous zones on your body, either alone or as a couple. Or you could work with a sex therapist to find ways to cope with your new body image and sensation issues.

My body shape changed after breast surgery. Part of it was missing and I would hide that. I have put on weight now and my breast is pretty much normal.

Amanda


Urinary problems

After some types of cancer treatment, some people can have problems with leaking urine (incontinence) or difficulty passing urine. This may be temporary, but it can sometimes be permanent. It can affect your confidence and how you feel about yourself sexually. If urine leakage is a problem for you, talk to your doctor or specialist nurse. They may suggest pelvic floor exercises to improve control.

Although it might seem embarrassing, it is a good idea to discuss incontinence with your sexual partner. Be honest with them. Tell them that a little urine may leak during sex. You can let them know that urine is sterile and it will not cause an infection for them. Good personal hygiene will help you feel more confident.

Some women find that penetrative sex makes the incontinence worse. If this happens, you can explore other ways of getting sexual pleasure, such as foreplay, massage and oral sex. Trying different sexual positions may also help.

Your doctor or specialist nurse can give you advice on different ways of coping with incontinence. They can also refer you to a continence adviser for further support.

Other things could try include:

  • avoiding drinking too many fluids for an hour or so before you have sex
  • emptying your bladder before
  • having sex in the shower
  • keeping a towel or tissues close by.

If you have a catheter

Sex is still possible if you have a urinary catheter (a tube in the bladder that drains urine out of the body). Your nurse, or a continence adviser, can discuss this with you.

You can tape the catheter out of the way on your leg or hip. Try different sexual positions to find the ones that are more comfortable, and that don’t put pressure on the catheter.

In some situations, it may be possible to remove the catheter before sex. Your nurse, or a continence adviser, can show you how to remove your catheter.


Bowel problems

Bowel problems are sometimes a side effect of cancer treatment, especially pelvic radiotherapy. These problems include loose bowel motions (diarrhoea), and needing to open the bowels with very little or no warning (faecal incontinence). These effects may be temporary, but they can sometimes be permanent.

Problems with your bowels can have a huge impact on your life. It may make you feel less interested in sex. You may feel embarrassed and your confidence may be affected. You may feel unclean or unattractive, and you may want to avoid intimate contact.

You can discuss bowel problems with your doctor or specialist nurse, or with a dietitian. They may be able to reduce the side effects using a combination of medicines, dietary changes and exercises. They can also help you cope with the way the problems are making you feel.

There are things you can do to help you cope with bowel problems:

  • Avoid eating foods that cause you bowel problems for several hours before sex.
  • Empty your bowels just before you have sex.
  • Good personal hygiene will help boost your confidence.
  • Scented candles may help if you are concerned about smells.
  • Let your partner know that you may have to rush to the toilet.
  • Make sure you can get to the toilet quickly and easily.
  • Have tissues and towels nearby during sex.
  • You could use an anal plug. They are available online. Your doctor or specialist nurse can give you advice.


Stomas

Sometimes, surgery for bowel or bladder cancer involves having an opening made in the abdominal wall. This is called a stoma. A stoma allows waste from your body (either urine or bowel motions) to drain into a bag that covers the stoma. This is called a colostomy bag.

Having a stoma can make some sexual positions uncomfortable. It can also affect your self-confidence and the way you feel about your body. You can reassure your partner that sex will not harm the stoma. To reduce rubbing against the stoma, choose positions that keep your partner’s weight off it.

It is not recommended to use a stoma for penetrative sex. Your doctor or specialist nurse can discuss this with you further.

Make sure the bag fits well and does not leak. It is a good idea to empty the bag before sex. Some foods can cause the bag to fill quickly, so avoid eating or drinking anything that usually causes you problems. You may be able to plug the stoma or wash it out, so that a bag is not needed for a short time.

Stoma nurses can advise and help you with all of the sexual effects a stoma may cause. Information is also available from the Ileostomy and Internal Pouch Support Group or the Sexual Advice Association.


Treatment for head and neck cancer

The face, mouth and speech can play important parts in your sex life. Changes to any of these can affect how you interact sexually. They can also affect your confidence and how you feel about yourself.


Changes to speech

If there are certain things you do or do not want your partner to do sexually, let them know before having sex. You can also agree alternative ways to communicate what you want during sex.

Changes to your mouth

Surgery or radiotherapy may affect your ability to kiss or give oral sex. It may also cause problems making saliva or controlling saliva. If you have a dry mouth, deep kissing and giving oral sex may be uncomfortable.


Loss of a limb

Very occasionally, a surgeon may need to amputate an arm or leg when treating some types of cancer (such as primary bone cancer). The limb will often be replaced with an artificial arm or leg (a prosthesis).

It can be very difficult to come to terms with a major body change such as amputation. The feeling of looking different from other people can affect your self-confidence.

Whether to wear your prosthesis when having sex is a personal choice. You may find it helps with positioning and movement. Or you may find sex easier and more comfortable without it.

Some sexual positions you enjoyed before surgery may no longer be comfortable. You may need to try different positions to find what you now prefer. You can use pillows to help with positioning and balance. Your physiotherapist or occupational therapist can give you advice if needed.


Lymphoedema

Lymphoedema is swelling that develops because of a build-up of fluid in the body’s tissues. It can affect your sex life and change the way you feel about your body. The following advice might help you find sex more comfortable and enjoyable:

  • Try sexual positions that don’t put weight on the area affected.
  • Have sex at times when the swelling is low. This might be in the morning, or after you have worn a compression garment for a few hours.
  • If you have genital lymphoedema, use extra lubricant to reduce friction to the skin.

We have more information about lymphoedema.


Health and well-being

Your physical health and well-being can affect your sexual function and self-confidence. Read more about reducing stress, physical activity, stopping smoking, cutting down on alcohol and eating well in our section on maintaining a healthy lifestyle.

Back to Effects of treatment on a woman's sexuality

The female body and sex

Cancer can affect your sexual desire and arousal. Knowing women’s sexually sensitive areas and how your body behaves may improve your sex life.