Sex and chemotherapy

Some people carry on with their sex lives as normal during chemotherapy. Others find their treatment changes how they feel emotionally or physically. Most of these changes won’t last long. They won't affect your sex life permanently.

Sometimes you may feel:

too tired
not strong enough to be very active
sick or sore
not in the mood
unhappy with changes to your body
anxious or low

There's usually no medical reason to stop having sex during chemo. The drugs won't have any long term physical effects on your performance or enjoyment of sex. You can’t pass cancer on to your partner during sex.

Sex and chemotherapy for women

Sometimes chemotherapy can cause women to have an early menopause. Symptoms from the menopause may affect your sex life for a while.

Most women going through the menopause have some symptoms. These include:

hot flushes
night sweats
anxiety, low mood and mood changes
feeling very tired (fatigue) and poor sleep
problems with thinking, concentration and memory – sometimes called brain fog
a dry vagina
less interest in sex
joint pains and muscle aches and you may have thinning and weakening of the bones (osteoporosis) over time
headaches and worsening migraines
itching, irritation or dryness of your vulva or vagina
vaginal pain or discomfort during sex
vaginal bleeding after sex
urinary problems such as needing to wee urgently, infection or incontinence

Help with symptoms of early menopause

There are a range of treatments and things you can do to help cope with the effects of menopause. You may need to try different things before you find something that works for you.

After you finish chemotherapy, you might be able to have replacement therapy (HRT). HRT doesn't prevent the menopause, but it can help with the symptoms. Your specialist might advise you not to take HRT if you have a hormone dependent cancer Open a glossary item , such as breast cancer. Check with your healthcare team before starting to make sure it is safe for you.

If your vagina is dry and sex is uncomfortable, your doctor can prescribe a cream or ointment for you. Or you can use a lubricant to moisten your vagina. You can get these from your chemist without a prescription. There are a variety of lubricants available. So if one doesn’t suit you, there are others you can try.

Some people find that olive oil is a useful lubricant. But don’t use it if you’re using condoms or dental dams as it may damage them. It’s important to take advice from your healthcare team.

Sex and chemotherapy for men

Rarely, chemotherapy can make a man’s testosterone levels drop. Testosterone is the male sex hormone. So some men find that while they’re having treatment, they lose interest in sex.

Chemotherapy can also affect the nerves that control erections. So you may have trouble getting and keeping an erection.

These changes are usually temporary. They don’t last more than a couple of weeks after the treatment has finished.

High dose treatment

Higher doses of chemotherapy are more likely to affect your sex life. You may have high dose chemotherapy with a stem cell or bone marrow transplant.

Many people having this treatment have radiotherapy as well. This combination is more likely to make you lose your sex drive or have erection problems.

This may happen during treatment and for a while afterwards. Research shows that high dose treatment reduces some men’s testosterone levels for a while.

Most of these side effects are temporary, but treatments are available. These include hormone replacement and drugs to help you get and maintain an erection.

Contraception to avoid pregnancy

It’s important to use reliable contraception during treatment. Avoid getting pregnant or getting someone else pregnant while you are having chemotherapy. This is because the drugs may harm the baby.

Talk to your healthcare team about what type of contraception is best for you. This might depend on:

your cancer type
your medical history

For example, if you have a hormone dependent cancer or have a risk of blood clots, it might not be safe for you to use hormone based contraceptives. This includes the contraceptive pill, the contraceptive injection, or the intra uterine system (IUS).

Protecting your partner

It is not known for sure whether chemotherapy drugs can be passed on through semen or secretions from the vagina. So some doctors advise using a barrier method (such as condoms, femidoms or dental dams) if you have sex during treatment. This applies to vaginal, anal or oral sex.

Generally, you only need a barrier method when you are having treatment and for about a week afterwards. You may be asked to use contraception for longer to avoid pregnancy. The length of time depends on the chemotherapy you have.

Advice like this can be worrying, but this does not mean that you have to avoid being intimate with your partner. You can still have close contact with your partner and continue to enjoy sex.

Talking about sex and chemotherapy

Talk to your healthcare team before your chemotherapy starts if you're worried about the effects chemotherapy might have on your sex life.

They can discuss:

the general side effects to expect from your treatment
how these side effects might affect your sex life

Try not to feel embarrassed about discussing sexual problems with your healthcare team. If sex is an important part of your life, you need to know about any possible changes. They are used to answering questions about sex.

Discuss your feelings and any worries with your partner too. Even though there's only a small chance you will have problems with sex, your partner may feel worried. Your partner could go with you if you decide to have a chat with your doctor or nurse.

Other help and support

You or your partner could also contact an organisation that helps with relationships and sexuality issues. Some of these organisations have useful factsheets that they can send to you.