Living with and beyond cancer

Sexual functioning and intimate relationships

Having treatment for cancer can affect a person’s ability to feel good about themselves sexually, or their physical ability to give and receive sexual pleasure. This may be due to the physical effects of certain cancer treatments or to psychological issues. For many the changes will be temporary. For others they will be long-lasting or permanent. This doesn't need to mean the end of their sex life as there are many ways of adapting and developing new ways of giving and receiving sexual pleasure. Advice is available from professionals and, with support and clear communication, it can still be possible to enjoy fulfilling intimate relationships.
 
While a few people we spoke to said that they had continued having sex with their partner during their cancer treatment, most said that their illness and its treatment had temporarily made them less interested in sex (loss of libido) because they were feeling too ill or tired or they didn’t feel good about their body.  People can worry that they could pass on their cancer to their sexual partner but this is not possible. Many people said that once they had recovered from the short term effects of surgery or other treatments they were able to resume a normal sex life, a few saying they enjoyed sex more after their treatment. A woman who had ovarian cancer surgery said that her husband became temporarily impotent afterwards because penetrative sex felt different. Those who were not in a sexual relationship at the time said that sex was not an issue for them.
For others the impact of cancer on their sexuality and sexual activity was longer-lasting or permanent. Some were still in treatment several years after their cancer diagnosis and still experiencing effects that had been temporary for other people. For instance, people taking hormone therapy for several years could experience loss of libido throughout the treatment (see Hormone changes’). A man with lymphoma said that long-term use of steroids had affected his libido. Similarly, those with chronic or slow growing cancers of the blood had a tendency to feel tired a lot of the time.
For women, cancer surgery could cause damage to nerves or a shortening of the vagina, altering the sensations experienced during sex for themselves or their partner. For instance, a woman who had a hysterectomy for cervical cancer said her vagina had changed shape and she didn’t experience the same responses during sex. Lasting vaginal dryness resulting from pelvic radiotherapy, hormone therapy or the menopause can make it difficult for women to have penetrative sex.
The sexual functioning of men can be permanently damaged by certain cancer treatments. Men who have one cancerous testicle removed usually have no long-term sexual problems. However, hormone therapy (e.g. for prostate or breast cancer in men), pelvic radiotherapy and surgery for prostate, bladder, or colorectal cancer can all affect a man’s ability to achieve or maintain an erection. This is known as impotence or erectile dysfunction. Nowadays this can be overcome with medicines (such as Viagra (sildenafil)), injections, implants or a type of vacuum pump. Men may find it difficult to discuss such a personal issue openly but health professionals are very used to dealing with this problem and can give advice. Among the men we spoke to, several had used medicines to help them lead an active sex life, whereas others had either declined an offer of help or had not wanted to ask for help from their health professionals.
A man who had breast cancer treatment was prescribed Viagra afterwards but he hadn’t used the pills and he and his wife no longer bother with penetrative sex but find other ways to be intimate. A man who was left impotent after surgery and radiotherapy for colorectal cancer wasn’t allowed Viagra because he had a history of heart attack; he feels bitter about losing his sexual function.
 
Penile cancer is rare and commonly treated with surgery. The extent of surgery depends on the size and position of the tumour, and reconstructive surgery may be an option. Men may find it difficult to come to terms with having surgery on their penis, but it need not necessarily mean the end of a sex life, although those who have their whole penis removed can no longer have penetrative sex.
For some people their lack of desire to engage in sexual activities was less to do with physical problems and more to do with how they felt about their body after treatment (see also Body image or sense of identity). People who have had body parts removed or have unsightly scars from surgery may feel a loss of confidence in their body and be reluctant to be seen naked even by long standing partners. Norma said she had never worn a nightdress in her married life but started doing so after her colorectal cancer surgery, to hide her scars from her husband. Having a breast removed (mastectomy) can leave a woman feeling unattractive. Using a colostomy or ileostomy bag to collect their faeces through a hole in the abdominal wall (stoma) after surgery for colorectal cancer, can leave people feeling both unattractive and unclean.
It was common for people to say that because they were getting older they were not so concerned about changes to their sex life than if they had been younger. Some implied that this was their reason for not having discussed their difficulties with a professional.
Many stressed the importance of the support and understanding demonstrated by their spouse or partner in coming to terms with changes in sexual functioning. Some said that they now slept apart from their spouse. One man said this was because of the night sweats he had because of his lymphoma.
Although many people had been reticent to seek help with sexual difficulties, advice is available from doctors, nurses and sex therapists. A woman with ovarian cancer was offered sex therapy but after discussing it with her husband she declined the offer. After seeking help, Christopher said he had a better sex life than ever.


Last reviewed August 2015.

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