Dating and Sex for Young Adult Cancer Survivors: Expert Answers

October 25, 2018
Winifred Mak, MD, PhD

Winifred Mak, MD, PhD, is assistant professor of the Department of Women’s Health, Dell Medical School at the University of Texas at Austin. She is a specialist in reproductive endocrinology and infertility, working with people with cancer and survivors for their fertility preservation needs.

This content was developed in collaboration with LIVESTRONG.

Young adulthood is when many people start dating and having sexual experiences. And, it’s normal to be concerned about how having a history of cancer could affect your sex life or how a person you may be interested in romantically will react to your medical history.share on twitter Answers to these 3 common questions may help you feel more informed and at ease as you pursue new relationships.

1. Do people want to date someone who had cancer?

This is a prime time in life for dating. But do you feel afraid to try because you had cancer? Have you ever asked yourself if people want to date cancer survivors? A recent study from Europe addressed this very question. The researchers gave people from a dating website and a group of college students a pretend profile of either a person who had survived cancer or a person who never had cancer and asked the participants whether they would likely date this person. Reassuringly, there was no difference in the desire to date a survivor of cancer versus a person with no cancer history. The research also showed that most people would want to hear about the cancer diagnosis after a few dates, rather than before or on the first date. 

2. Will I have sexual problems, and are there solutions?

In adults, research shows that a person’s sex life can change after having cancer and cancer treatment. Common issues are lack of desire to have sex, pain in the outside or inside of the vagina or penis or testicles, decrease in vaginal lubrication, erection problems, and difficulty getting aroused. Though less well studied, there is research showing that childhood cancer survivors are also more likely to experience problems with sexuality and sex. Understanding what those potential problems are can help you prepare to navigate intimacy.

A recent study in Sweden sent a questionnaire to 285 male and female cancer survivors ages 15 to 29 regarding their fertility, body image, and sexuality. Researchers compared their responses to 255 people of similar age and gender who did not have cancer. They found that adolescent young adult (AYA) cancer survivors have a lower satisfaction with sex than peers who have not gone through cancer treatment. In girls and women, there was lower frequency of orgasm during sex that may have been related to vaginal pain and lack of vaginal lubrication. Depression was linked to these feelings of dissatisfaction with sex. In boys and men, there was much less sexual desire in AYA cancer survivors than in their peers, mainly due to erectile dysfunction.

The good news is that there are often simple solutions to problems with sex. For example, if a woman has vaginal dryness during sex, lubricants can help. It may be that, due to cancer treatment, the ovaries aren’t producing enough female hormones to keep the vagina lubricated. If vaginal pain is a problem, this may also be due to lack of female hormones. In either case, young women should visit their gynecologist for an exam to see whether estrogen cream can be recommended. More specialized assistance may be needed if there are problems with sexual arousal, orgasm, or erection. Be sure to talk with a member of your cancer care team on how to find solutions for you.

3. Should I worry about my fertility?

Another recent study found that survivors of adolescent cancer are concerned about their ability to have children in the future. Not all cancer treatments affect the ovaries or testicles. Certain chemotherapies and radiation therapy can be “gonadotoxic,” which mean they can destroy eggs and sperm. But in people treated during childhood, there may still be some reserve eggs or sperm in the ovaries or testicles. If you have concerns about female infertility or male infertility due to previous cancer treatment, consider talking with a fertility specialist a year before you want to conceive so you can get a physical assessment of your reproductive health and review the current options for fertility assistance, if needed. 

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