Sexual wellness

This page was reviewed under our medical and editorial policy by

Alexandria Callahan, LCPC, BC-DMT, GLCMA, Behavioral Health Team Manager

This page was reviewed on February 15, 2024.

Many cancer patients undergo changes to their sexual function and relationships following diagnosis and during cancer treatment. They may experience body image changes or loss of libido, develop intimacy challenges with their partner or experience pain or other challenges during sexual activity.

Patients with any type of cancer may experience some level of sexual dysfunction, but those with breast cancer, prostate cancer or a reproductive or urinary cancer are especially at risk for symptoms and side effects that may affect their sexual health.

The patient's cancer care team should include experts trained in helping patients address physical and psychological challenges that may cause sexual dysfunction and stress on their relationships.

Cancer and sexual health

Cancer and its treatments may result in a variety of symptoms and side effects that may directly or indirectly affect sexual function. Several such treatments are listed below.

Radiation therapy may damage sexual organs or cause skin irritation.

Surgery may impact tissue or organs involved in sexual function and cause body-image issues. Ostomies, scarring or nerve changes can impact the intimate experience.

Hormone therapy may interfere with the body’s natural hormone balance.

Chemotherapy may cause fatigue, digestive issues and hair loss.

Other side effects of cancer and its treatment that may affect sexual wellness include:

  • Anxiety and depression
  • Pain
  • Vaginal scarring, tightness and/or dryness
  • Erectile dysfunction
  • Premature ejaculation
  • Painful intercourse

Integrative care services for sexual wellness

The care team will work with the patient and his or her partner to develop a plan to manage sexual side effects, or prevent them when possible, so the patient may maintain healthier relationships and enjoy an improved quality of life. Some of the integrative care services that may help include those listed below.

Behavioral health: Counseling is available for the patient alone or with a partner.

Nutritional support: A dietary plan may help with digestive issues and weight management while supporting mood and energy.

Psychiatry: A doctor may conduct an emotional assessment and discuss medication options.

Spiritual support: Chaplains are available to conduct spiritual and family counseling.

Urologic oncology: Experts trained in treating diseases of the urinary tract may be called in to evaluate and help manage issues.

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Pelvic floor therapy

The pelvic floor is made up of three layers of muscles in the base of the pelvis. These muscles support internal organs, help control urinary and bowel functions and play a key role in sexual health.

Some cancers, especially gynecologic and urinary tract cancers, may weaken or damage the pelvic floor, leading to a variety of side effects, including:

  • Leakage of urine or stool
  • Painful intercourse for women
  • Lower back pain
  • Erectile dysfunction
  • Premature ejaculation

Physical therapists are trained in the evaluation and treatment of pelvic floor dysfunction. Physical therapy programs designed to strengthen the pelvic floor muscles may help relieve the side effects of cancer treatment and help to improve the patient's quality of life.

Pelvic floor therapy services and strategies may include those listed below.

Physical exercises: Kegels—contracting, holding and releasing the pelvic floor muscles—and aerobic exercise may help increase strength.

Hydration and nutrition: Avoiding certain beverages, especially alcohol and caffeinated drinks, may help address incontinence.

Relaxation techniques: Deep breathing and mental distraction techniques may help patients learn how to relax their pelvic floor muscles.

Biofeedback: Sensors placed in specific areas of the abdomen and backside offer sensory feedback that helps patients retrain and strengthen the pelvic floor muscles.

Sexual function improvement techniques: Vaginal dilators, topical vaginal moisturizers or lubricants may help reduce pain during sex.

The care team will work with integrative care clinicians to explore medical and supportive care options to address the patient's specific pelvic floor dysfunction challenges.

Mastectomy products

Mastectomy products are designed for patients who have undergone mastectomies, lumpectomies, reconstruction and/or radiation therapy. Patients can request an appointment with a garment educator for questions relating to finding mastectomy products, insurance coverage or local or online shops and/or getting a signed prescription.