Managing sexual complications

Some sexual health issues that arise during cancer treatment are temporary and improve after treatment ends, while others may be long-term or develop after treatment. Your oncologist can discuss how different treatments may affect your body.

How cancer treatments affect sexual health in women

Chemotherapy

• Lowers estrogen levels, potentially causing early menopause (primary ovarian insufficiency)

• May stop the ovaries from producing hormones and releasing eggs

• Can cause hot flashes, irregular or absent periods, vaginal dryness and vaginal tissue changes (sores)

• Pregnancy should be avoided during chemotherapy—talk to your oncologist about birth control options

• In some cases, these changes may be permanent

Hormone Therapy (Endocrine Therapy)

• Reduces estrogen levels, which may trigger early menopause symptoms

• Common side effects include hot flashes, irregular or absent periods and vaginal dryness

Radiation Therapy to the Pelvic Area

• Can lower estrogen levels, leading to vaginal dryness

May cause:

• Vaginal stenosis (narrowing, shortening and reduced elasticity of the vagina)

• Vaginal atrophy (weakened vaginal muscles and thinning vaginal walls)

• Vaginal itching, burning and inflammation, which can make intercourse painful

Surgery and Body Image Changes

• Surgeries (e.g., breast cancer surgery) may affect self-image and sexual confidence

• Certain procedures can alter physical sensations and function, impacting sexual health

Medications

• Opioids and some antidepressants may lower sex drive

If you are experiencing sexual health concerns, talk to your cancer care team at TMC Health Cancer Center. They can offer guidance, treatment options and support tailored to your needs.

Many men experience temporary sexual problems during cancer treatment that improve after treatment ends. However, some side effects may be long-term or develop after treatment. Your oncologist can discuss how different treatments may impact your sexual health.

How cancer treatments affect sexual health in men

Chemotherapy

• May lower testosterone levels and decrease libido (sexual desire or energy) during treatment

• Typically does not affect erectile function

• Should use precautions to avoid causing pregnancy while undergoing chemotherapy treatments.

Radiation Therapy (External Beam and Brachytherapy)

• Treatment to the pelvic area (anus, bladder, penis or prostate) can affect sexual function

Possible side effects include:

• Erectile dysfunction (difficulty achieving or maintaining an erection) due to nerve or blood vessel damage

• Dry orgasm (climax without ejaculation) due to prostate damage

Hormone Therapy

Lowers testosterone levels, leading to:

• Reduced sexual drive

• Erectile dysfunction

Surgery

• Procedures for penile, rectal, prostate and testicular cancer may damage nerves, leading to erectile dysfunction

Medications

• Pain medications, antidepressants and drugs affecting nerves and blood vessels may lower libido and affect sexual function

If you’re experiencing sexual health concerns, talk to your cancer care team at TMC Health Cancer Center. They can provide treatment options, support and strategies to help manage these changes.

Sexual activity during cancer treatment

Most men and women can remain sexually active during cancer treatment, but it’s best to confirm with your oncologist if there are times when you should abstain. If you are still undergoing chemotherapy, take necessary precautions to prevent pregnancy.

How your cancer care team can help

Learn about your treatment options.

For men:

• Oral medications

• Penile injections

• Penile implants

• Vacuum-constriction devices (pumps to encourage blood flow and erections)

• Complementary therapies (acupuncture, relaxation techniques)

For women:

• Vaginal gels, creams, lubricants or moisturizers

• Vaginal estrogen cream

• Pelvic floor exercises to improve bladder control, bowel function and blood flow

• Dilators to prevent or reverse vaginal scarring caused by radiation therapy or graft-versus-host disease

Use condoms when advised

• To prevent partner exposure to chemotherapy drugs, which may remain in semen or vaginal secretions.

Manage related side effects

• Talk to your doctor about pain, fatigue, hair loss, loss of interest in activities, sadness or trouble sleeping, as these may affect your sex life.

Get support and counseling

• Share your feelings with people you trust.

• Consider professionally led support groups.

• Your oncology nurse or cancer care team can help connect you with support groups or counselors.

Talking with your health care team about sexual complications

As you navigate the changes that cancer treatment brings, it can be helpful to prepare a list of questions for your cancer care team. Open communication can help you better understand and manage sexual side effects.

Questions to ask your cancer care team

• What sexual complications are common for men and women receiving this treatment?

• What sexual side effects am I likely to experience during cancer treatment?

• When might these changes start?

• How long will these complications last? Are any of these changes permanent?

• What prevention, treatment or management strategies do you recommend?

• Do you have a list of support groups that can help?

• Are there specific times during treatment when I should refrain from sex or use a condom?

As you adjust to cancer-related sexual changes, remember that your health care team is here to support you. They can provide guidance, treatment options and resources to help you navigate these challenges.