Both men and women may experience sexual problems from cancer or cancer treatment. Side effects differ between men and women; however, even though it may feel awkward, it is important to discuss the symptoms you experience with your doctor or other member of the health care team. If your doctor does not seem comfortable or experienced with these concerns, ask if he or she can refer you to a social worker or someone else on the team who may be more helpful. There are various options available to help manage the sexual problems you may encounter.
Sexual problems, which may be caused directly by treatments or indirectly by psychological reactions and mood, experienced by people with cancer generally fall into one of four categories:
- Libido (sex drive) or desire disorders, which is the decrease or loss of sexual fantasies and desire
- Arousal disorders, which include the inability to achieve or maintain sexual arousal, such as lubrication or swelling in women and an erection in men
- Orgasmic disorders, which is the delay or absence of orgasm following normal arousal, such as premature ejaculation in men
- Pain disorders, which is genital pain during sexual intercourse
Relieving side effects is an important part of cancer care and treatment. Talk with your health care team about any symptoms of sexual problems you may experience, including any new symptoms or a change in symptoms. Getting help for these issues is important because sexual health is part of having a good quality of life.
Remember that intimacy is very closely connected to the larger relationship as well as one's feelings about one's self. If there are tensions anywhere else, they probably will be reflected in a sexual relationship. Generally, people are less interested in sex than usual while undergoing active treatment and at times of crisis. During recovery and survivorship, interest in sex usually improves.
Sexual dysfunction may be caused by one or more of the following:
- Physical changes from cancer surgery, chemotherapy, hormonal therapy, or radiation therapy
- Hormone changes
- Nausea and vomiting
- Medications that can reduce libido
- Fear of recurrence (return of the cancer)
- Changes in self image
- Unhappiness or embarrassment with physical changes
If you think that one of the above reasons is contributing to your sexual difficulties, ask the doctor to address this issue. For example, many people undergoing cancer treatment experience fatigue, which can take away strength and energy. Learning how to manage fatigue often improves other side effects. Furthermore, managing pain and other side effects of cancer treatment often improves how a person feels.
It is important to have an honest discussion about sexual problems with your doctor, nurse, or other member of the health care team. Remember that it is completely normal to experience concerns around intimacy and sexuality during and after cancer treatment. One of these professionals can help explain typical reactions to a given cancer treatment and refer you to a healthcare professional who specializes in treating sexual dysfunction, if needed. Often, there are solutions to these common sexual problems. Before meeting with the health care professional, you may want to think about the following:
- Your sexual activity before cancer
- How cancer has changed your sexual activity
- Any existing or potential problems in your relationship
Honest, open communication with your spouse or partner often improves some sexual issues and might help with any tension you feel about a change in your sexual relationship. Finding a good counselor, who has experience working with patients with cancer and talking through some of these issues, can help you and your partner.
Managing physical sexual side effects in women
For women who experience vaginal pain or dryness, the following treatments may help:
- Hormone replacement therapy (only for cancers that will not be affected by hormone treatments)
- Low dose vaginal estrogen for cancers that will not be affected by hormones; discuss this option with your doctor, because this treatment often affects a woman's quality of life and should be factored into this decision.
- Vaginal moisturizers or lubricants. There are many products available, and most can be purchased online. Two excellent, inexpensive, and non-embarrassing suggestions are canola oil and Albolene (which is sold as a face cleanser).
- Vaginal dilators, which help gradually expand the vagina. These require a prescription and are most helpful for women who have had pelvic-area surgery. If you use them, it may be more comfortable in a warm bath.
- Anesthetic gels (to help with pain). Be aware that this solution may have an unintended consequence for male partnersâthe gel may also result in a man losing his erection as he, too, loses sensation.
Managing physical sexual side effects in men
For men with erection problems, the following may help to increase sexual desire and potency:
- Medications to help men achieve and maintain an erection, such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra)
- Penile implants
- Medications to increase blood flow to the penis, such as intraurethral alprostadil (Caverject, Edex, or Muse) and intracavernous papaverine (sold under multiple brand names)
- A tube called a vacuum constriction device (VCD) that you place over the penis to create suction
- A prosthesis (artificial implant) that is surgically placed into the penis
Talk with your doctor about the potential risks and side effects before using any medication or device.
LIVESTRONG: Female Sexual Dysfunction
LIVESTRONG: Male Sexual Dysfunction
Last Updated: April 27, 2012