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Intimacy, Sex & Fertility Issues

At times, side effects from cancer treatments and the stress of the cancer experience can lead to sexuality and intimacy issues with a partner or loved one. In addition, some types of cancer treatment can impact your ability to have children. There are specific steps you can take to address both intimacy and fertility concerns. Above all, talk with your doctor or nurse about your concerns—you are not alone with these issues and there is help available.

Many types of cancer and their treatments can cause sexual problems. Some common sexual issues reported by people with cancer include:

  • Loss of fertility or fertility problems in men and women
  • Loss of sexual desire
  • Erectile dysfunction 
  • Discoloration of sperm or ejaculate after treatment with chemotherapy (short term)
  • Pain associated with intercourse for women
  • Vaginal dryness
  • Muscle weakness in women
  • Early menopause

A cancer diagnosis can change the way you feel about yourself and how you relate to others. Your physical appearance may change because of your treatment. Some changes in your body may be temporary; others might be permanent. Talk about these changes with your health care provider. A referral to a sexual health specialist may be helpful.

You may experience feelings of grief and loss, anxiety, and depression. These are all normal responses. It is helpful to talk with people you trust and feel comfortable with sharing your feelings, including your health care team. Resources and support are available to you. Having a conversation with your partner, however difficult it may be, is particularly useful in clarifying concerns and feelings either of you may be experiencing so you may work through any issues. Open communication with your partner can contribute towards maintaining a satisfying, healthy relationship.

Coping with Intimacy and Sex Issues

  • Communication is essential. Talk with your partner and your health care team. Even if you do not have a steady partner, talk to your health care team.
  • During active treatment, and in periods of neutropenia, you are at increased risk of infection. Talk to your team about engaging in sexual activity during this time.
  • Discuss the use of birth control (for women, many providers will discontinue your use of the pill during treatment).
  • Discuss the use of contraceptives during active treatment (routinely advised to use condoms and/or alternative contraceptives during this time) not only to prevent infection (i.e. urinary track infections (UTIs), yeast infections) but to prevent pregnancy during this period. 
  • Vaginal dryness is a common side effect. Speak with your health care team if you are experiencing this symptom. There are medications that can be prescribed to help.
  • Sexual health and fertility specialists are often found within hospitals.
  • Be open to discovering new ways you and your partner can connect and feel close.

 Coping with Fertility Issues

Those who think they may want to explore having children after a cancer diagnosis should let their doctor know as soon as possible, even before treatment has begun. Some options that are available such as sperm or egg banking, or tissue freezing may need to be initiated before treatment begins.

Insurance coverage is not consistent for these procedures, so ask your insurance company what is covered before you begin. If banking or tissue freezing is not a viable option for you, you may want to discuss alternatives such as adoption, surrogacy, or a donor with your health care team.