Sexuality and fertility

Chemotherapy can affect your sexuality and fertility in emotional and physical ways. These changes are common. Some changes may be only temporary while others can be permanent.

Learn more about:

• Changes in sexuality
• Using contraception
• Changes in fertility
  • Effects of chemotherapy on ovaries
  • Effects of chemotherapy on sperm

Changes in sexuality

You may notice a lack of interest in sex or a loss of desire (libido), or you may feel too tired or unwell to want to be intimate. You may also feel less confident about who you are and what you can do.

There may 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 feel concerned about having sex – they might fear injuring the person with cancer, feel uncomfortable with the changes in their partner or worry about being exposed to chemotherapy drugs.

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 changes to how you feel about yourself, 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 our podcast on Sex and Cancer.

Using contraception

As chemotherapy drugs can harm an unborn baby, your doctor may talk to you about using contraception during and after chemotherapy. Although chemotherapy often affects fertility, it doesn’t always.

If you are in a heterosexual relationship and sexually active, you will need to use some form of contraception to avoid pregnancy while having treatment. If you or your partner become pregnant, talk to your specialist immediately.

You will also need to use some form of barrier contraception (condom, female condom or dental dam) to protect your partner from any chemotherapy drugs that may be present in your body fluids.

Changes in fertility

Chemotherapy can affect your ability to have children (fertility), which may be temporary or permanent. 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), embryos or ovarian tissue, 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. Some women are able to have hormone injections to reduce activity in the ovaries and protect eggs from being damaged by chemotherapy.

For more on this, see Fertility and cancer.

Effects of chemotherapy on ovaries

Chemotherapy can reduce the levels of hormones produced by the ovaries. This can cause your periods to become irregular or even stop for a while, but they often return to normal within a year of finishing treatment. If your periods do not return, the ovaries may have completely stopped working, causing early menopause.

After menopause, women can’t conceive children naturally. Signs of menopause include hot flushes, night sweats, aching joints, dry or itchy skin, and trouble sleeping. 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 or ask for a referral to a specialist menopause clinic.

Effects of chemotherapy on sperm

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 (erectile dysfunction or impotence) may also be affected, but this is usually temporary. If impotence is ongoing, talk to your doctor.