Sex and intimacy after cancer treatment

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science.

This page was updated on April 29, 2022.

Cancer changes your life, and that may include your sex life, too. Intimacy after cancer may be influenced by the types of treatment you receive, your self-image, the emotional toll you endure, as well as the physical toll. Your sexuality refers to how you see yourself as a sexual being and how you express it with your body and mind through the lens of your lifestyle, self-esteem, upbringing, beliefs and, of course, health.

After cancer treatment, sexuality may feel different or interrupted for some time. Having sex may not feel the same way it did before cancer. Your desire to have sex may have changed. You may feel differently inside. This is all normal.

The most common issues related to intimacy after cancer treatment are vaginal dryness for women and erectile dysfunction (ED) in men, but there are other possible concerns.

While this is a challenging time, intimacy doesn’t have to be complicated forever. In your own time, it’s possible to accept and embrace any changes in your body and regain the desire you once had. You may speak with your care team, explore treatments and support, and gain back the pleasure you experienced before cancer.

Common sex and intimacy issues

Many people with cancer experience one or more of these issues at some point after treatment.

Pain during sex/vaginal dryness: Women who’ve undergone cervical cancer treatment, surgery or radiation may experience vaginal dryness or pain (dyspareunia) during sex.

Gynecologic cancers and their treatments may shorten or narrow the vagina, and this also may factor into pain during sex. Some treatments may even prompt menopausal symptoms that contribute to vaginal dryness and vaginal tightness.

Breast cancer survivors also may experience vaginal dryness, loss of libido and the inability to orgasm due to the hormone treatments that alter estrogen and androgen levels.

Body image issues: You may experience weight gain, hair loss or the inability to control your bladder, and this could impact the way you see yourself and your overall energy. When something changes your feeling of sexuality, it may impact your libido.

Surgery may alter your appearance as well. For example, women who’ve had a mastectomy may feel less comfortable with their appearance and less sensation. They may feel sexually unattractive.

Because cancer may change how you look—due to surgery or other treatments—it’s a normal reaction to feel down at first.

Trouble reaching orgasm: Many people who experience orgasms before cancer have them again. If it’s a problem, ask your care team for tips and strategies. A sexual counselor may also help.

Erectile dysfunction: ED is a common side effect in men with cancer. Surgery or radiation may impact the nerves and flow of blood and affect an erection. In addition to ED, men may have problems reaching orgasm or have urine leakage while climaxing.

Because of these issues, men may experience loss of interest in sex and loss of self-confidence.

Lower libido: Many of the issues mentioned above may alter sexual desire. Some medications, such as hormone therapy, antidepressants and pain medications, may also lower libido.

Fertility: Treatments such as radiation, chemotherapy and surgery impact fertility. Treatments for men may alter hormone production that influences healthy sperm and fertility. Treatments for women may cause an irregular menstrual cycle or damage eggs.

Not all treatments negatively affect fertility, however. The type of cancer, dosage of drugs, amount of radiation, age and genetics all play a role in how cancer impacts fertility.

While fertility doesn’t influence sex necessarily, it may impact intimacy with your partner and your self-esteem, resulting in a loss of sexual desire.

Longer-term issues after treatment

Long-term sexual dysfunction is a possibility after cancer treatment.

This may result from physical and emotional changes. Damage to pelvic nerves, blood vessels and organ structures may occur during treatments, which may contribute to sexual dysfunction.

After childhood cancer treatment, sexual dysfunction appears to persist in female survivors more so than male survivors.

Tips on getting your sexual life back

To reclaim your sexual identity, begin by exploring your feelings surrounding your image and what’s important to you, ultimately, in terms of intimacy. Then take baby steps toward making change. It’s not wrong to feel apprehensive, low self-esteem or anxiety surrounding the changes in your body and libido.

But you don’t have to hold these feelings inside. It’s important to address any issues of helplessness, depression or anxiety when it comes to sex and intimacy. Consider speaking with your care team about your emotions and weigh out your options when connecting back to your sexual life or your partner.

Some methods that may help:

  • Focus on what you love about yourself.
  • Focus on how cancer, and surviving it, made you stronger.
  • Explore ways to get closer to your partner.
  • Focus on intimacy more than intercourse. Cuddling, kissing and massages may be beneficial in reclaiming your sexuality.

For side effects that require medical intervention—such as erectile dysfunction or vaginal dryness—discuss treatment plans with your care team. Medications or counseling may be options in activating your sexual desires. Women may incorporate Kegel exercises, unscented and water-based lubricant or vaginal dilators to manage painful sex. Doctors may prescribe a low-dose estrogen pill for vaginal dryness. For men, doctors may prescribe a medication like Viagra® or Cialis® to increase blood flow.

For all patients, communication with your partner is incredibly important. Helping your partner understand your emotions may bring you closer together. Consider implementing the following tips into your sex life:

  • Work on relaxing.
  • Consider yoga and mindfulness practices.
  • Experiment with different positions.
  • Keep in mind that having an orgasm doesn’t have to only happen during intercouse. Open your mind to other options like sex toys or exterior play like breast play.

Finding support

Sexual dysfunction after cancer treatment is a common side effect. Talk with your care team to let them know what’s going on in order to find a solution and proper follow-up care.

Be open and help your care team understand your sexual orientation and gender identity, and any surgeries or medications you have had to transition.

You may ask your care team questions such as:

  • What can I expect from this treatment or surgery in terms of intimacy?
  • How long would this side effect last?
  • Is this something I can work on myself, or do I need a medical intervention?
  • How common is this for someone who had my cancer or my treatment?
  • Should I see a therapist?
  • Do you have any recommended reading on this topic?

Additionally, find a support group of other cancer survivors. The National Cancer Institute offers helpful tips on finding one.

It’s important to remember everyone’s experience is different. Emotions, physical appearance and relationships vary from person to person. However, your sex life doesn’t have to be entirely disrupted. Moving forward, staying dedicated and working with your care team may help ensure a positive road for you and intimacy.

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