Sex and fertility

Chemotherapy can have an impact on your desire (libido) or ability to have sex. It may also affect sexual organs and functioning in men and women. This can affect your ability to have children (fertility).

Learn more about:

• Changes in sexuality
• Using contraception
• Changes in fertility

Changes in sexuality

A range of issues can cause people to lose interest in sex while they’re having treatment. Aside from feeling tired and unwell, you may feel less confident about who you are and what you can do. There may also be a physical reason for not being able or interested in having sex, e.g. vaginal dryness or erection difficulties. Changes in appearance can also affect feelings of self-esteem and, in turn, sexuality.

If you have a partner, it may be helpful for them to understand the reasons why your libido has changed and to know that people can have a fulfilling sex life after cancer, but it often takes time. Some partners may also feel concerned about having sex – they might fear injuring the person with cancer or feel uncomfortable with the changes in their partner.

If you have sex after receiving chemotherapy, follow these contraception recommendations.

Sexual intercourse may not always be possible, but closeness and sharing can still be a part of your relationship. Talk about how you’re feeling with your partner and take time to adapt to any changes.

Try to see yourself as a whole person (body, mind and personality) instead of focusing only on what has changed. If you’re worried about the changes to your relationships or sexual functioning, you may find talking to a psychologist or counsellor helpful.

For more on this, see Sexuality, Intimacy and Cancer, and listen to The Thing About Cancer podcast episode on sex and cancer.

Using contraception

Your doctor may talk to you about using contraception during and after chemotherapy. Although chemotherapy often affects fertility, this doesn’t mean it rules out pregnancy. Some women can still become pregnant while having chemotherapy, and a man having chemotherapy could still make his partner pregnant.

Chemotherapy drugs can harm an unborn baby, so women should plan to avoid becoming pregnant during chemotherapy treatment, and men should not father a child. If you or your partner become pregnant, talk to your specialist immediately.

The type of birth control you choose will depend on what you and your partner are comfortable using. Some people use barrier contraception such as a condom or female condom, which provides protection against any chemotherapy drugs that may be present in their body fluids.

Changes in fertility

If you want to have children in the future, talk to your doctor about how chemotherapy might affect you and what options are available. Women may be able to store eggs (ova) or embryos, and men may be able to store sperm for use at a later date. This needs to be done before chemotherapy starts and requires careful consideration. For more on this, see Fertility and Cancer.

Effects of chemotherapy on women

Chemotherapy can reduce the levels of hormones produced by the ovaries. For some women, this causes periods to become irregular during chemotherapy but they return to normal after treatment. For other women, chemotherapy may cause periods to stop completely (menopause). After menopause, women can’t conceive children. Signs of menopause include hot flushes, sweating (especially at night), and dry skin. Menopause – particularly when it occurs in women under 40 – may, in the long term, cause bones to become weaker and break more easily. This is called osteoporosis. Talk to your doctor about ways to manage menopausal symptoms.

Effects of chemotherapy on men

Chemotherapy drugs may lower the number of sperm produced and reduce their ability to move. This can sometimes cause infertility, which may be temporary or permanent. The ability to have and keep an erection may also be affected, but this is usually temporary. If the problem is ongoing, to your doctor.