Sex and sex hormone symptoms in women

Some cancer treatments lower the amount of sex hormones in the body or stop the body producing them altogether.

The hormones most commonly affected in women are oestrogen and progesterone. Lower levels of these might affect your sex life.

Symptoms can include:

• a loss of sex drive (also called a low libido)
• vaginal dryness

Loss of interest in sex (libido)

In women, the hormones progesterone and oestrogen play a part in sex drive. But not everyone who has low hormone levels has a loss of interest in sex. For most people, the cause is a combination of factors including:

• your age

• your general health

• stress and worry

• tiredness

• loss of confidence and self esteem due do treatments such as a mastectomy

• other side effects of low hormone levels, such as hot flushes, pain, discomfort or loss of sensation in breasts or nipples

• loss of oestrogen can also cause a loss of desire to have sex or be intimate

What you can do about low sex drive depends on what is causing it. It is worth thinking about whether any of the factors listed above are relevant for you and if they could be making things worse.

For example, if you are tired, learning how to cope with it or treating the tiredness could help to increase your sex drive. Or it might be something else that is affecting your interest in sex. Do tell your doctor or nurse so they can help.

Other advice includes:

• increasing blood flow to the vulva region by using vaginal dilators or vibrators – this may help to increase arousal and pleasure
• strengthening your pelvic floor muscles. They play a role in your sex life. You can learn how to do pelvic floor exercises by, for example, using an app called 'Squeezy'
• self-touch and taking control during sex can also help with pleasure

Vaginal dryness in women

Reduced amounts of sex hormones in women can cause vaginal dryness. This is very uncomfortable and sexual activity can be painful. Pain during sex is the most common problem for women who have had cancer treatment, affecting their sex hormones.

Oestrogen helps to maintain the firmness of the wall of the vagina. Without oestrogen, the vagina and vulva may become thinner, more easily damaged, and less elastic. The tissues make less of the secretions that help keep the vagina healthy and make sexual intercourse comfortable.

Taking painkillers such as paracetamol 30 minutes before intercourse may help relieve discomfort.

Laser treatment may help increase the production of collagen in the vagina. This will help to improve the firmness of the vaginal wall. This treatment is not available on the NHS.

If you have vaginal dryness, you might also have itchiness and discharge. 

Lubricants and moisturisers

Non hormone treatments might help. These include moisturisers and lubricants.  You put these into your vagina and around the vulva if you need it.

You usually use moisturisers regularly, for example a few times a week. These include Replens or Hyalofemme. The effects last longer than a lubricant. Many women find that this reduces feelings of dryness and itching in the vagina and vulva. It improves personal comfort even if they do not plan to be sexually active.

Pjur, Yes and Sylk lubricants can be used, but Durex or some other branded lubricants are not recommended. The ingredients may change the pH levels, causing further discomfort, dryness, itchiness and possible infection.

Lubricants in the form of oil, silicone or water can be used on demand or during intimacy as they rapidly relieve dryness or discomfort without leaving any residue. These lubricants are non sticky and feel natural.

Vaginal oestrogen

Ask your doctor about whether you could use vaginal oestrogen if lubricants and moisturisers do not help. These can help to moisturise the vaginal area. You can either use a cream, gel, vaginal ring or pessary. A pessary is a small pellet that you put inside your vagina, where it gradually dissolves. 

Your body will absorb some oestrogen, but the amounts are small. Research suggests that it does not raise the levels of oestrogen in the blood very much. Some people are worried that this might cause their breast cancer to come back. Researchers did a systematic review and meta analysis  in 2025. It showed that vaginal oestrogen doesn’t increase the risk of breast cancer coming back in people with a history of breast cancer. Talk to your doctor to see if this might be an option for you.

Another treatment for vaginal dryness is a pessary called DHEA. It works in a slightly different way to vaginal oestrogen. Your doctor or nurse would need to prescribe this. It is different to the DHEA supplement available online.

Hormone replacement therapy (HRT)

One way to help control hormonal symptoms is to take hormones to replace the ones your body is no longer producing. Hormone replacement therapy (HRT) is an effective treatment for many women. But some treatments for breast cancer aim to either stop the body producing sex hormones, or block their action. If you are having these treatments, you can’t unfortunately take HRT.

Doctors don’t routinely recommend that you take HRT if you have a hormone dependent cancer, such as breast cancer. Even if you have finished treatment there is concern that HRT may increase the risk of cancer coming back. Talk to your specialist if you are finding it difficult to cope with your symptoms. They can explain the risks and benefits of HRT and if this is an option for you.

Coping

If you are in a relationship, it is important to talk to your partner about how you feel.

Sometimes if you lose your interest in sex it stops you making the effort to enjoy other physical contact with your partner. This can be very difficult for you both. Even if you are not interested in having sex, you can still enjoy physical contact.

Be clear about what physical contact you want

Hugging, cuddling and kissing are comforting and can help you to relax. If you have physical contact it is important to be clear with your partner about how far you are expecting to go.

You might want to put sexual activity on hold for a while. Some people find having other physical contact can gradually lead to them becoming aroused. 

What else can affect sex drive?

Some anti depressants can cause a low sex drive. For example, SSRI antidepressants such as Prozac. Talk to your nurse or doctor if you are taking anti depressants and think they may be affecting your sex drive.

Help and Support

If you’re worried about anything to do with your sex life or sexuality, you may want to talk through how you’re feeling. You could do this with a counsellor or therapist. Or you could contact some of the organisations that offer support and information.