Intimacy, Sex and Fertility Issues

Little baby shoes

Sometimes, side effects from cancer treatments and the stress of having cancer can lead to sexuality and intimacy issues with a partner. In addition, some types of cancer treatment can affect your ability to have children. There are steps you can take to address both intimacy and fertility concerns. Talk with your doctor or nurse about these issues. They can provide help.

Many types of cancer and their treatments can cause sexual problems. These may include:

  • Loss of fertility or fertility problems in men and women
  • Loss of sexual desire
  • Problems getting or keeping an erection
  • Color changes of sperm or ejaculate after treatment with chemotherapy (short term)
  • Pain associated with sex for women
  • Vaginal dryness
  • Muscle weakness in women
  • Early menopause or changes in regularity of menstrual cycle

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. You may have short-term and long-term changes in your body. Talk about these changes with your health care provider. A referral to a sexual health specialist may be helpful.

You may feel grief and loss, anxiety, and depression. These are all normal. Talk with people you trust and feel comfortable sharing your feelings with, including your health care team. They can offer resources and support. It can be hard for you to talk with your partner about the concerns and feeling both of you are having. But it can help you to maintain a satisfying, healthy relationship.

Coping with Intimacy and Sex Issues

  • During active treatment, and when you have a low white blood cell count (called neutropenia), you are at increased risk of infection. Ask your health care team if you can engage in sexual activity during this time.
  • Discuss the use of birth control. Many providers will advise women to stop using the pill during treatment.
  • Talk about using contraceptives during active treatment. Doctors usually advise using condoms or other contraceptives during this time. This prevents infections such as urinary track infections (UTIs) and yeast infections. It also prevents pregnancy. Some anticancer drugs can be excreted into the semen and vaginal fluid. Using condoms can also prevent exposing the patient's partner to the drug.
  • Vaginal dryness is a common side effect. Your health care team can prescribe medications to help with this.
  • Your health care team may be able to refer you to sexual health and fertility specialists.
  • Be open to discovering new ways you and your partner can connect and feel close.

Coping with Hot Flashes

  • Avoid spicy foods, alcohol, and smoking.
  • Avoid saunas and hot baths or showers.
  • Wear layered clothing, preferably cotton.
  • Exercise.
  • Use deep, slow abdominal breathing techniques.
  • Try acupuncture*—some people find that this can help relieve a number of their symptoms. Talk to your health care team first. It isn’t always covered by insurance.

Coping with Fertility Issues

If you are thinking of having children, let your doctor know as soon as possible, even before you have started treatment. Some options such as tissue freezing or sperm or egg banking may need to begin before treatment starts.

Before you begin any of these procedures, check with your insurance company to see if they will cover them. If banking or tissue freezing is not an option for you, you may want to talk to your health care team about alternatives such as adoption, surrogacy, or a donor