Sexuality and intimacy

Cancer and its treatment may affect your sexuality and intimacy in physical and emotional ways. These changes may be temporary or ongoing and can be difficult to deal with.

Sexual difficulties can affect any cancer survivor, but those most likely to experience long-term sexual problems include:

  • women treated for breast or gynaecological cancers
  • women who experience early menopause
  • men treated for testicular or prostate cancer
  • people treated for cancer of the rectum or lower bowel
  • people who have had head and neck surgery
  • people who have a stoma because of their treatment.

Some people say they were not prepared for the sexual changes caused by treatment. Others say they avoid all forms of intimacy, including hugs, kisses and sharing feelings, because they’re afraid this may lead to sex when they don’t feel physically up to it.

You may not even be aware that you aren’t taking an interest in sex or being as intimate as you were before. If you have a partner, they may feel confused or uncertain about how to react. Let your partner know how you’re feeling and any fears you have about sex. Ask your partner how they’re feeling – they may be worried about hurting you or appearing too eager. You may want to ask your partner to do things differently or talk about other ways of being intimate.

Some people worry that they will never be able to have an intimate relationship again. For most people, sex is more than arousal, intercourse and orgasms. It involves feelings of intimacy and acceptance, as well as being able to give and receive love. Although sexual intercourse may not always be possible, closeness and sharing can still be part of your relationship.

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Common sexual problems after cancer treatment

General Women Men
  • Loss of interest in sex
  • Tiredness and fatigue
  • Changed body image
  • Feeling sexually unattractive
  • Incontinence
  • Painful intercourse
  • Depression or anxiety
  • Relationship changes or pressures
  • Difficulty reaching orgasm
  • Vaginal dryness
  • Reduced vaginal size
  • Loss of sensation
  • Pelvic pain
  • Menopausal symptoms
  • Difficulty getting or maintaining an erection
  • Ejaculation difficulties

Managing sexual difficulties

  • Seek professional advice and support. Talk to your doctor (with or without your partner). A referral to a sex therapist or physiotherapist may help.
  • If you’re having erection problems, ask your doctor if medicine can help.
  • If radiation therapy or surgery has narrowed or shortened the vagina, you may be advised to use a vaginal dilator to help keep the walls of the vagina open and supple.
  • Show affection by touching, hugging, massaging, talking and holding hands.
  • Do some physical activity to boost your energy and mood. Talk to your GP if your low libido is caused by depression.
  • Be intimate at the best time for you (e.g. when your pain is low or energy levels high).
  • Take some pain-killers before having sex if you have ongoing issues with pain.
  • Spend more time on foreplay and try different ways of getting aroused: shower together, have a weekend away, dance, wear something sexy. Do whatever makes you feel good about yourself.
  • Use a water or silicone-based lubricant during sex. Avoid products with perfumes or colouring to reduce irritation.
  • Try different positions during sex to work out which is the most comfortable for you.
  • If sexual penetration is painful or difficult, explore different ways to orgasm or climax.
  • If you feel comfortable, stimulate yourself. This may reassure you that you can still enjoy sex. Or you may want to stimulate your partner and help them reach orgasm, even if you don’t want any stimulation for yourself.

This information was last reviewed in April 2018
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