The physical and emotional changes brought on by cancer and treatment may affect sexuality, fertility, reproductive health, and sexual relationships. Learning how to cope with these changes can help your recovery and well-being.

Physical changes and sexuality

Some cancers and cancer treatments directly affect sexuality through physical changes to the sexual organs. For example, treatment for cervical, vulvar, and penile cancers may include surgical removal of part or all of a reproductive organ. For women, chemotherapy and radiation therapy to the pelvis can damage the ovaries and reduce the amount of hormones they produce. Women may also experience early menopause or symptoms common to menopause, such as vaginal dryness, vaginal infections, and reduced libido (sex drive). Breast cancer may, but usually doesn't, result in removal of one or both breasts. With a lumpectomy, some loss of the breast may occur and a scar may be visible.

In men and women, chemotherapy and radiation therapy frequently cause fatigue (tiredness), as well as nausea, diarrhea, and mouth sores. These side effects may significantly reduce sexual interest. Loss of libido is the most common sexual concern for cancer survivors.

Emotions, body image, and sexuality

Some of the changes affecting sexuality are emotional rather than physical. Fear, anxiety, stress, and depression all reduce libido. You may also find that you are less interested in sex because your attention and energy are focused on cancer and the current treatment.

Body image concerns may affect sexuality. Cancer and cancer treatment may change the way your body looks and how you feel about your appearance. Changes to your fertility or the loss of a testicle or a breast may not affect sexual performance directly, but for some, they can affect how you feel about your attractiveness and sexuality. Even if cancer has not changed your physical appearance, you may feel differently about your attractiveness and sexual desirability.

Coping with sexual concerns

Sexuality is an important part of life for young adults. The following suggestions may help you cope with common sexual concerns during or after cancer treatment:

• Difficulties, such as loss of libido, pain during intercourse, and problems achieving orgasm, may have a medical cause. Talk with your doctor about this possibility and treatment options.
  
  
• Give yourself time to adjust to body changes before resuming or beginning a sexual relationship.
  
  
• Remember that sexuality involves much more than intercourse. Explore other ways of building intimacy, arousal, and sexual gratification.
  
  
• If you have scars or other body changes, it may make you feel more comfortable to let your partner see and touch these areas of your body before any sexual activity.
  
  
• Sexual activity may need to be less spontaneous at first. It may be helpful to plan around those times of the day when you experience fatigue or pain.
  
  
• Honest and open communication is essential. Talk with your partner about your fears and concerns and let your partner know how he or she can help you.
  
  
• In the same way, encourage your partner to share his or her concerns.
  
  
• Individual, couples, and/or sex therapy can help you and your partner address sexual and body image concerns in a comfortable setting.

Although some young adults are married or have a long-term partner, many are single. For additional information on dating and sexual relationships for single adults, see Cancer and Being Single.

Cancer and pregnancy

It is possible to become pregnant or to impregnate someone during cancer treatment. Some cancer treatments may harm the fetus and cause birth defects. It is important to talk with your doctor about these risks and to use a reliable form of birth control if you are sexually active during cancer treatment. For more information, see Pregnancy and Cancer.

Additional Resources

American Cancer Society: Sexuality for Women and Their Partners

American Cancer Society: Sexuality for Men and Their Partners

Mayo Clinic: Cancer and loss of libido: How treatment affects desire

Mayo Clinic: Sexuality after cancer treatment: What women can expect

Mayo Clinic: Sexuality after cancer treatment: What men can expect

More Information

Cancer.Net: Body Image and Sexuality

Cancer.Net: Cancer in Young Adults