Radiotherapy, sex and fertility

During and after radiotherapy, it is usually safe to have sex. But, you should use contraception to: 

  • prevent pregnancy during radiotherapy and for a time after
  • protect yourself from infection.

It is normal to lose interest in sex if radiotherapy is making you tired, unwell or anxious. This can change how you feel about your body or make you feel less confident. 

Pelvic radiotherapy can also cause changes that may affect your sex life such as 

  • early menopause and vaginal changes 
  • problems with erections and ejaculation 
  • changes to the anus and rectum.

Your radiotherapy team will tell you what to expect. They will explain if there is a risk of long-term side effects or side effects that happen months or years later. 

Radiotherapy to the pelvis or to the pituitary gland may affect your ability to start a pregnancy (your fertility). Before you start treatment, your team will explain if there is a risk of infertility. Sometimes it is possible to collect your sperm, eggs or ovarian tissue to use in the future to start a pregnancy.

Sex during radiotherapy

During and after external radiotherapy, it is usually safe for you and a partner to have sex. For some types of internal radiotherapy, there may be times during and after treatment when you should avoid having sex or close physical contact. Your team will explain more.

If you have any type of radiotherapy, you should use contraception to:

  • prevent pregnancy during radiotherapy and for a time after
  • protect yourself from infection.

There are many different types of contraception. Ask your team for advice about the safest type to use during your treatment.


Side effects and sex

Side effects of radiotherapy can change how you feel about having sex. It is normal to be less interested in sex if you are tired, unwell or anxious. Changes such as hair loss may change how you feel about your body or make you feel less confident. For a time, men may find it difficult to get or keep an erection.

It may help to remember that most of these side effects are usually short-term and get better after you finish radiotherapy. Although it can be upsetting to lose interest in sex, things usually improve as the side effects get better.


Pelvic radiotherapy and sex

Radiotherapy to the pelvic area can cause side effects that may make having sex difficult. Sometimes these effects can be long-term or happen months or years after radiotherapy. These are called late effects. Before you decide to have treatment, your team will tell you what side effects are likely.

The pelvis is the area between the hips in the lower part of the tummy. You might have radiotherapy to this area to treat cancer of the:

Side effects of pelvic radiotherapy may include the following. You can ask your team about treatments and advice that can help with these side effects. We have more information about pelvic radiotherapy for men and for women.

Early menopause and vaginal changes

Women who have not already had it may start the menopause. This can cause many symptoms, including vaginal dryness. Radiotherapy to the vagina or vulva can also make these areas drier and less stretchy. These side effects may mean sex is less comfortable or that it is harder to orgasm.

Problems with erections and ejaculation

Radiotherapy to the pelvis may cause difficulties getting an erection or ejaculating. This sometimes develops months or even years after the radiotherapy has finished.

Changes to the anus and rectum

Treatment to the anus or rectum may make these areas more fragile and less stretchy. This may make anal sex difficult or painful.

Late effects of pelvic radiotherapy

Hear about some possible late effects of pelvic radiotherapy and advice on how to deal with them in the long term.

About our cancer information videos

Late effects of pelvic radiotherapy

Hear about some possible late effects of pelvic radiotherapy and advice on how to deal with them in the long term.

About our cancer information videos


Coping with effects on your sex life

If you find a side effect difficult to cope with during or after radiotherapy, talk to your healthcare team. You may feel embarrassed talking about it, but your team can help. They may be able to give you information or support to cope with a problem. Sometimes they can arrange for you to see other professionals, for example a specialist doctor or counsellor.

We have more information about cancer and your sex life for men and for women. You can also find information and support about sex on the College of Sexual and Relationship Therapists website. If you want to talk to a cancer information nurse, call us on 0808 808 00 00.


Effects on fertility

Radiotherapy to most areas of the body does not affect your ability to get pregnant or make someone pregnant (your fertility).

However, your fertility may be affected if you have treatment to:

  • the pelvic area – the area between the hips in the lower part of the tummy
  • the pituitary gland – a small gland at the base of the brain.

Radiotherapy to these areas can affect how your body produces:

  • the hormones (chemical messengers) needed to control sex
  • the egg or sperm cells needed to start a pregnancy.

It can also cause physical changes that:

  • make it difficult to get an erection or ejaculate
  • mean you cannot get pregnant or carry a pregnancy.

Before you decide to have treatment, your team will explain any risks to your fertility. For some people, radiotherapy causes changes that get better with time. For others, the treatment they have to the pelvic area or pituitary gland causes permanent infertility.

Your team may talk to you about fertility preservation, if this is possible for you. For men, fertility preservation usually means collecting and freezing sperm. For women, it can mean collecting and freezing eggs or pieces of ovary. If you have a male partner, sometimes collected eggs can be fertilised with their sperm. If suitable embryos develop, these may be frozen.

Fertility preservation is not always possible. But it may mean some people who lose their fertility are still able to have a baby in the future. We have more information about fertility preservation for men and for women.

Preventing pregnancy

Even if your team tell you your fertility might be affected by the treatment, it is not always possible to know when this will happen. You may still be able to get pregnant or make someone pregnant.

Whatever your gender, you should use contraception to prevent a pregnancy during your radiotherapy and for a time after. Your team can give you more information about this.

Coping with infertility

People cope with the idea of losing their fertility in different ways. You may come to terms with it quickly and feel that dealing with the cancer is more important. Or you might find that the impact does not hit you until treatment is over.

Whatever you are feeling, there is support if you want to talk or have questions. It does not matter whether you are starting cancer treatment or had treatment in the past. You may find it helps to talk things over with your partner, family, friends, or religious or spiritual adviser. If you want to talk to a counsellor, your GP or cancer doctor can help to arrange this. Fertility clinics also provide counselling.

Organisations such as the British Infertility Counselling Association (BICA) can offer support and counselling to people affected by infertility. Talking to other people in a similar position may also help you feel less alone. Get in touch with our Online Community at macmillan.org.uk/community

It was a difficult and confusing time for us, because at the time of diagnosis we were young, so we hadn’t really thought about children and family.

Neesha

Cancer treatment and fertility

Robert talks about having treatment to preserve his fertility when he was diagnosed with Hodgkin lymphoma.

About our cancer information videos

Cancer treatment and fertility

Robert talks about having treatment to preserve his fertility when he was diagnosed with Hodgkin lymphoma.

About our cancer information videos

Back to Radiotherapy explained

What is radiotherapy?

Radiotherapy uses high-energy rays to destroy cancer cells. This treatment aims to treat cancer or relieve symptoms.

Before your radiotherapy

Before you start radiotherapy, your team will explain what your treatment involves and how it may affect you.

Masks for radiotherapy

During most types of radiotherapy to the brain, head or neck, you wear a mask to help you keep still.

Your radiotherapy team

You will meet many different specialists from your radiotherapy team. You may see them before, during and after radiotherapy treatment.

After your radiotherapy

It can take time to recover from radiotherapy. Support is there if you have any problems.