Sex life after anal cancer treatment
Most people can have a normal sex life after having anal cancer. This does depend on what your sex life was like before. And you'll also need time to recover from any treatment you've had.
The effects mentioned here don't affect everyone who has anal cancer treatment. They may get better over time. But, occasionally, the changes can be permanent. The side effects you have will depend on what treatment you have.
Your doctor or nurse can tell you more about how your treatment might affect your sex life. You may feel embarrassed to talk to doctors or nurses about sexual problems. Remember that they deal with these things all the time, so try not to feel embarrassed to talk about them. If you tell them about any problems you have, they can find ways of helping you to deal with them.
Some hospitals have counsellors that are trained to talk about aspects of your sex life after cancer treatment. Your specialist nurse can refer you to this type of service.
Effects on your sex life
You should not have sex for quite a few weeks after major surgery such as an abdominal perineal resection (APR). Your surgeon will tell you how long to wait. But there is no reason why chemoradiotherapy should stop you from making love.
Many people do not feel like having sex while they are having treatment. Try not to worry about this. Side effects and general tiredness are bound to get in the way.
Surgery to the bowel or back passage (rectum) can affect the nerves to the sex organs. This can cause sexual problems in both men and women. Radiotherapy and chemotherapy can also cause changes which can affect your sex life.
A man may not be able to get or keep an erection and may have dry orgasms. There are several treatments available for erectile problems.
A woman might have an early menopause or dryness and narrowing of the vagina. Your doctor or nurse will suggest lubricants and vaginal dilators to use after your treatment. Using dilators helps to stretch the vagina. Your doctor may also discuss using hormone replacement therapy for an early menopause.
After radiotherapy
Radiotherapy can cause scarring of the anus. This might affect the way your anus works. Some people may have problems controlling their bowels (faecal incontinence).
In the long term, radiotherapy can change the lining of the bowel, which can cause some bleeding from the anus. These side effects can make anal sex difficult. But some treatments can help. Talk to your doctor if you are worried about this.
After surgery
You might have surgery to remove your anus and rectum as part of your treatment for anal cancer. If you're used to having anal sex, you will no longer be able to.
Your surgeon and specialist nurse will talk to you about this before and after your surgery. This can have a big impact on your sex life. There are other ways to enjoy a fulfilling sex life. Sharing your thoughts and feelings with your partner, if you have one, can help with this.
Chemoradiotherapy can affect your ability to have children (fertility). Your healthcare team should discuss this risk with you when you are diagnosed. You can get support to help you cope.
Having sex after a colostomy
If you've had a colostomy, you might feel self conscious about the change in your body. You might worry about how the colostomy will affect your intimate relationships. Or you may be anxious about practical things like the stoma bag being noticeable or smelling during sex. A common worry for many people is that their partner will reject them.
Stoma bags are well designed. They're not visible under your clothes and shouldn't smell. If you do notice a smell, talk to your stoma nurse. It may be that the stoma bag doesn't fit well. The nurse can advise you on using a different type.
Intercourse won't harm your stoma. Make sure that your stoma bag is securely attached. Most positions you choose for having sex won't affect your stoma bag. Find one that is most comfortable for you. You can also explore wearing underwear that covers the stoma. Pouch covers for the colostomy bag are also available.
Talking openly with your sexual partner can help your fears of rejection to disappear. Most of the time, partners want to try to understand what you're going through and help if they can. This experience is also new to them. You may need time to feel confident enough to have sex again. Remember that you can still be intimate with your partner through cuddling and kissing.
You can read more about life with a colostomy, including having sex, on the Dansac website.
Getting help
It often helps to talk things over with your partner and explain how you feel. It will take time for both of you to come to terms with all that has happened to you.
Your doctor and specialist nurse are also there to offer support. Your side effects may get better over time, but sometimes they can be permanent. If you feel worried, talk to your doctor or nurse. It’s normal to feel embarrassed when talking about sexual problems. Your doctor and nurse are sensitive to this and will understand.
Your doctor or nurse may be able to offer treatments that can help with your problems. They can also refer you to a specialist such as a counsellor or sex therapist for further support. You may decide that you want to talk to a specialist counsellor alone at first. You can invite your partner along in future.
If you're single, you might worry about how to tell a new partner about the changes to your body. It can be hard to talk about how certain problems might affect intercourse. A counsellor or sex therapist can help you find a way to do this.
