Sexual wellness

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science.

This page was reviewed on June 29, 2022.

Many cancer patients undergo changes to their sexual function and relationships during their treatment journey. They may experience a 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 or a reproductive or urinary cancer are especially at risk for symptoms and side effects that may affect their sexual health.

At City of Hope, our care teams 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. For example:

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.

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

Our services

Your care team at City of Hope will work with you and your partner to develop a plan intended to manage sexual side effects, or prevent them when possible, so you can maintain healthier relationships and improve your quality of life.

Our team provides numerous services to help manage the sexual side effects of cancer, including:

Behavioral health: Counseling is available either 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 and emotional assessment and discuss medication options.

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

Urology: Oncologists trained in treating diseases of the urinary tract may be called in to evaluate and help manage issues.

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Meet our sexual wellness nurses

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

At City of Hope, our 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 your quality of life.

Pelvic floor therapy services and strategies may include:

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

Hydration and nutrition: Strategies to avoid 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.

Your City of Hope care team will work with integrative care clinicians to explore medical and supportive care options to address your specific pelvic floor dysfunction challenges.