Coping with cancer-related sexual challenges with your partner

Sexuality is part of living a fulfilling life, but sometimes a cancer diagnosis or treatments can affect desire, arousal or sexual function. For couples, these side effects can hurt their relationship and impact their quality of life.

“Cancer shouldn’t stop you from doing things you enjoy, including sexual intimacy,” says Michael Roth, M.D. In fact, it can help you manage your mental health. “Sex can be a healthy way for you and your partner to cope with stress,” says social work counselor Jillian Bissar.

Here, Roth and Bissar share ways couples can cope with cancer-related sexual challenges together. 

Cancer-related sexual challenges have both physical and emotional aspects

From physical changes to the emotional toll, cancer treatments such as surgery, chemotherapy and radiation therapy can disrupt your sex life. For example, men who’ve undergone prostate cancer treatment may have trouble getting an erection. Breast cancer treatment can cause some women to go into early menopause, which can cause vaginal dryness and make sex painful.

The most common change is an overall loss of desire. “Hair loss, scarring or changes in body shape from surgery may make patients feel less attractive,” Roth says. Other treatment side effects like fatigue, nausea and anxiety can also affect your sex drive.

In addition, neuropathy can change the way our bodies feel – making touching that may have once been pleasurable feel uncomfortable.

But sometimes sexual challenges can be more emotional. “Patients sometimes say, ‘I’m just grateful to be alive; I shouldn’t be worried about my sex life,’” Bissar says. But it’s natural to feel emotional about the changes you may be experiencing. “Give yourself permission to grieve the loss of what your sex life used to be,” she adds.

Talk about your sexual needs during and after cancer treatment

Although talking about sex may make you uncomfortable, it’s important that you and your partner are open and honest with each other about your needs.

“Sex is a normal, healthy part of life,” Bissar says. “And talking about it will help you and your partner maintain intimacy.”

Being open with your partner can also help them understand what you’re facing so that they don’t feel isolated. MD Anderson patients can reach out to their care team or an MD Anderson social work counselor for advice on having these conversations.

Safe sex during cancer treatment

Unless your doctor tells you otherwise, it’s usually safe to have sex during cancer treatment. But ask your partner for permission first. “Safety and consent should always be considered,” Bissar says.

Certain procedures or treatments may pose risks for sexual activity. For instance, chemotherapy can be passed through bodily fluids like semen or vaginal fluid for up to 72 hours after an infusion.

“Using barrier protection such as a condom or dental dam can limit the risk of the passing chemotherapy on to your partner, since you do not want to expose them to toxic agents unnecessarily,” Roth says.

Patients on chemotherapy are also more vulnerable to infections – especially when their white blood counts are low. Using barrier protection can limit your exposure to harmful bacteria or sexually transmitted diseases.

If you’re in your childbearing years, using protection is especially important since chemotherapy can cause birth defects.

Lastly, sex can be a problem if you have bleeding in the genital area after surgery or if your platelets are very low. Roth and Bissar suggest talking with your doctor before participating in sex to ensure you and your partner are safe.

Find new ways to be intimate

Once you’ve accepted your new normal and addressed if sex is safe for you and your partner, Bissar advises looking for new opportunities for intimacy.

“Lots of pleasurable experiences are accessible to everyone,” Bissar says. She advises focusing on what you can do, instead of what you can’t do. For example, if fatigue means you don’t have the energy for intercourse, show your affection in other ways. “Kissing and certain touch don’t require much energy, but can be just as intimate,” Bissar says.

Most men and women are still able to have an orgasm even if cancer treatment interferes with erections or vaginal lubrication, or involves removing some parts of the pelvic organs. But it’s common for patients to need more time or stimulation to reach orgasm.

Take your time to adjust

There are many tools and exercises that can help you cope with cancer-related sexual challenges. And medications can help manage fatigue, vaginal dryness or erectile function.

“Talk to your care team to learn about options for you and your partner,” Bissar says.

When sexual changes do occur, they typically don’t improve right away. Finding the best fit for you and your partner may take time.

“Be patient and have fun exploring your new relationship together,” Bissar says.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.