Cancer and Sex
By Laura Farrington, DO and Ajaz Khan, MD
Q: I’m being treated for cancer. How will that affect my ability to have sex?
A: The impact on your sexual functions depends on what type of treatment you’re getting and what other health conditions might already be impacting your sexual function, among other things.
If you are undergoing chemotherapies, in the short term, these drugs can decrease estrogen and testosterone levels, which sometimes makes people have low libido and be less interested in sexual activity. These drugs may cause vaginal dryness in women and erectile dysfunction in men. For most people, these impacts on their sexual function are temporary — just while they’re going through treatment.
Q: If I do have sex while on chemotherapy, will the treatment somehow affect my partner?
A: While the effects of chemotherapy, immunotherapy, or hormone therapy on the person getting the drugs are known, there isn’t good data on how much of those drugs get into seminal fluid or into vaginal secretion. We think the risk is low that these drugs could be passed to a sexual partner through these bodily fluids, but because we don’t know the full risk, we recommend using barrier protection, like condoms, on the days the drugs are given.
Q: What if a surgical procedure alters my appearance (and my confidence)?
A: Surgeries for cancer can result in changes to a person’s physical appearance and can have quality-of-life impacts that contribute to people feeling unattractive. For example, someone who has prostate surgery may experience urinary dribbling and may have to wear a diaper in the weeks following surgery.Â
Many cancer patients who have had a surgery that alters their appearance, such as women who have had mastectomies, are worried their partners may not be attracted to them without their breasts or that breast implants will feel weird for their partners, but we’ve found that their partners often don’t share those concerns.Â
Those with erectile dysfunction may find that their partners consider penetrative sex a small part of their sex life, with snuggling, sensual touching, and other forms of intimacy being just as or more important. We encourage our patients to have open conversations with their partners; most of the time, they feel much better once they’ve had these discussions.
Q: I’m a private person and can’t bring myself to talk about sexual health issues with anyone. What might my doctor say?
A:Â Talk to your doctor about your sexual health, even though you may feel uncomfortable doing so. We have information to share with you that can put your mind at ease or provide you with what you need to support your sexual health.
In addition to medications and surgeries to support your sex life, there are physical therapy approaches and a wide variety of devices, ranging from penis pumps to help with erections, to covers for ostomy bags that will protect them from dislodging during physical activity.Â
There really is a lot that can be done to support your sexual health, but we need to hear from you in order to help. You may be squirming at the thought of talking to your doctor about sex, but keep in mind that we’ve heard it all. We promise you: Someone else has asked your questions before. If you’re really struggling with saying the words out loud, put words to paper, and hand it to your doctor in the office, or use your patient portal to send your doctor a note.
Laura Farrington, DO, is a medical oncologist at City of Hope Cancer Center Chicago, and Ajaz Khan, MD, is a medical oncologist and chair of the medical oncology department at City of Hope Cancer Center Chicago, Atlanta, and Phoenix.
Originally published in the Fall 2024/Winter 2025 print issue.
Stephanie Bouchard is a freelance journalist who writes about health and wellness, lifestyles, and pets.
