Impact on sexuality and intimacy

Head and neck cancer can affect your sexuality in emotional and physical ways. You may worry that you are less sexually attractive to partners or you may be grieving the loss of your former body. Reduced interest in sex (low libido) is common during cancer treatment. Tiredness, or anxiety about cancer returning, may also affect your sexual wellbeing.

Surgery to the mouth may reduce sensation in the tongue or lips. This can affect the enjoyment and stimulation from kissing, but sensation should return in 12–18 months. Side effects such as dry mouth, bad breath, poor tongue and lip movement, facial palsy, scars, or a stiff neck and jaw can also make kissing and oral sex difficult or less pleasant.

Surgery to your face and mouth may also cause problems with controlling saliva. If you have a dry mouth, kissing and oral sex may be uncomfortable. If your speech is affected, this may affect your self-esteem and ability to express yourself during sex.

You or your partner may be afraid of having sex if the cancer was HPV-related. Research has shown that it is uncommon for long- term partners of people infected with oral HPV to also be infected. New partners may be at risk and may want to use barrier contraception, but in most people the virus is cleared by the immune system.

Some people choose to express their feelings in other ways, such as hugging, holding hands or touching cheek-to-cheek. You may wish to talk to a counsellor or sexual health professional, by yourself or with a partner, to help you find solutions to any sexual changes.

For more on this, see Sexuality, intimacy and cancer or listen to our podcast on Sex and Cancer.