Sex, intimacy and fertility

Chemotherapy can affect your sex life 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:

• Physical and emotional changes
• Using contraception
• Changes in fertility
• Effects of chemotherapy on ovaries and sperm

Physical and emotional changes

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.

Physical factors affecting sexual activity

There may be physical reasons for not being able to have sex or not being interested in having sex (e.g. vaginal dryness or erection difficulties). Changes in how you look can also affect feelings of self-esteem and, in turn, your interest in sex.

Talk to your partner

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 usually have a fulfilling sex life after cancer, but it may take time. Some partners may feel concerned about having sex. They might be worried about injuring or hurting you, or being exposed to chemotherapy drugs during sex.

Finding new ways to connect

Even if some sexual activities are not always possible, there are many ways to express closeness. Talking openly with your partner about how you’re feeling can be difficult but it is often very helpful. It’s important to take time to adapt to any changes. If you’re worried about changes to how you feel about yourself, your relationships or sexual functioning, you may find talking to a psychologist, sex therapist or counsellor helpful.

Learn more about sex, intimacy and cancer, and listen to our podcast on Sex and Cancer below.

Using contraception

In most cases, your doctor will advise you to use some form of barrier contraception (condom, female condom or dental dam) during treatment and for a while after. This is to protect your partner from any chemotherapy drugs that may still be in your body fluids.

As chemotherapy drugs can harm an unborn baby, your doctor may talk to you about using contraception for some months 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 a reliable form of contraception to avoid pregnancy while having treatment. Talk to your specialist immediately if you or your partner become pregnant.

Changes in fertility

Chemotherapy can affect your ability to have children (fertility). This may be temporary or permanent. If you may want to have a child in the future, talk to your doctor before starting chemotherapy about how the treatment might affect you and what options are available.

Eggs (ova), embryos, ovarian tissue or sperm may be able to be stored for use at a later date. This needs to be done before chemotherapy starts. In some cases, hormone injections can reduce activity in the ovaries and protect eggs from being damaged by chemotherapy.

Learn more about fertility and cancer.

Effects of chemotherapy on ovaries

Some chemotherapy drugs 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 don’t return, the ovaries may have stopped working, causing menopause. After menopause, you can’t get pregnant naturally. Signs of menopause include hot flushes, night sweats, aching joints and dry or itchy skin. In the long term, menopause – particularly when it occurs under 40 – may cause bones to become weaker and break more easily. This is called osteoporosis. Talk to your treatment team or GP about ways to manage menopause symptoms.

Effects of chemotherapy on sperm

Some chemotherapy drugs can 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 (erectile dysfunction or impotence), but this is usually temporary. If erection issues are ongoing, talk to your doctor.

All my life I wanted to be a father. I didn’t want cancer to ruin my chances, so I stored my sperm before treatment started. I think of this as a bit of an insurance policy.

Zac

→ READ MORE: Other side effects

Podcast: Sex and Cancer

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