Sexual Health and Cancer: Help Is Available

Cancer and its treatment can affect sexual health in real ways. This happens for both men and women. It is common, not unusual or embarrassing. Real help exists. It usually starts with bringing it up. This topic often does not come up on its own at a busy appointment.

Prostate, penile, and testicular cancer treatments often affect sexual function. Common effects include trouble with erections, weaker orgasms, and changes in ejaculation. These effects can come from surgery, radiation, or hormone therapy. The pattern and timing vary by treatment type.

Treatment can cause vaginal dryness, tightness, and pain during sex. Some treatments bring on early menopause symptoms, like hot flashes. This happens especially when treatment affects hormone levels. Numbness and lower sexual desire are common too. These often come from a mix of physical and emotional causes together.

Body image worries can lower sexual desire. So can fear of how a partner will react, or worry tied to your diagnosis. Sometimes these matter even more than physical changes do. Depression, pain, and certain medicines can lower desire too, on their own. Sexual health after cancer sits at the meeting point of body and mind. It is rarely just one or the other.

Doctors and nurses are used to this topic, even if it does not come up first. Real help exists. Medicine, devices, pelvic exercises, vaginal treatments, and counseling can all help, once your team knows what you are dealing with. Staying silent usually means staying stuck with a problem that has real solutions.

A sex therapist can help with both the physical and emotional sides of these changes. A urologist can help with erection problems. A doctor familiar with cancer survivors can help with vaginal pain, sometimes with a referral to physical therapy. Ask your oncology team for a referral that fits your concern.

Sexual changes after cancer affect relationships too, not just the person who had cancer. Open, honest talk with a partner works better than silence, even when it feels uncomfortable at first. Touch and closeness without pressure toward sex can also help you stay connected. This matters while you work through physical changes together.

Support groups connect you with others who have faced similar changes. This can ease the isolation this topic sometimes brings. Many people find real relief just in learning that what they feel is common. It is not a sign something is uniquely wrong with them.

Many sexual side effects ease as you get further from active treatment, though the timeline varies a lot by treatment type and by person. Some effects are more lasting, but even those often respond to treatment, like medicine, devices, or therapy. Do not assume where you are right now is where you will stay permanently.

You can bring up sexual health concerns with your care team whether or not you have a partner right now. This is about your own body and your own quality of life, not just about a relationship. Your team should treat this as a normal part of your care either way.

Ask whether the sexual side effects you notice are expected for your treatment. Ask for a referral to a sex therapist or a doctor familiar with cancer survivors. Ask what treatments, like medicine or physical therapy, might help your specific symptoms.

• Call your care team now, day or night, or go to an emergency department if you run a temperature of 100.4°F (38°C) or higher, or you get chills, during a stretch of treatment when your blood counts may be low. CDC calls a fever during chemotherapy a medical emergency, not something to leave until morning. Do not take anything to bring it down first, because that can mask the problem.
• Call your care team the same day if it burns when you pass urine, or your urine looks cloudy or bloody. NCI lists both among infection signs to report.
• Call 911 or go to an emergency department if bleeding after sex keeps going despite steady pressure, or is heavy. Platelets can be low during treatment, and a bleed that will not stop is not a phone-call problem.
• Call your care team the same day if sex is followed by light bleeding, genital sores, swelling, or new discharge. NCI notes there are points in treatment when the risk of infection or bleeding is high enough that intercourse should be paused.
• Call your care team within a day or two if pain during sex keeps happening, or an erection problem, dryness, or loss of desire is not settling. None of this is something to wait out. Ask what is expected for your treatment and what can be done now.

• National Cancer Institute — Sexuality and Sexual Health.
• National Cancer Institute — Sexual Health Issues in Women and Cancer Treatment.
• National Cancer Institute — Sexual Health Issues in Men and Cancer Treatment.
• National Cancer Institute — Infection and Neutropenia during Cancer Treatment.
• Centers for Disease Control and Prevention — Fever and Cancer Treatment.