Reproductive and sexual problems can occur after you receive chemotherapy. Which, if any, problems develop depends on your age when you are treated, the dose and duration of the chemotherapy, and which chemotherapy drugs are given.
Sexual changes men may experience
- Most men getting chemotherapy still have normal erections. A few, however, may develop problems. Erections and sexual desire often decrease just after a course of chemotherapy, but usually recover in a week or two. A few chemotherapy drugs, for example cisplatin or vincristine, can permanently damage parts of the nervous system. Although it is not yet proven, these drugs may interfere with the nerves that control erection.
- Chemotherapy can sometimes affect sexual desire and erections by decreasing the amount of testosterone produced. Some of the drugs used to prevent nausea during chemotherapy can also upset a man’s hormone balance, but hormone levels should return to normal after treatments have ended.
- Many chemotherapy drugs can affect sperm and the parts of the body that produce them. Some of these effects may be permanent. Freezing sperm before chemotherapy begins is one option for men who wish to father children later. (If you would like to read more about this, see our document called Fertility and Cancer: What Are My Options?)
- Although it is sometimes possible to father children during chemotherapy, the toxicity of some drugs may cause birth defects. Because of this, it is recommended that all men getting chemotherapy use a reliable type of birth control if they have sex. Condoms can also protect your partner from exposure to the chemotherapy drugs that may be in semen.
- Chemotherapy may suppress your immune system. If you have had genital herpes or genital wart infections in the past, you may have flare-ups during chemotherapy.
- Chemotherapy is often given through an IV tube into the bloodstream. However, new ways have been developed to get drugs directly to a cancerous tumor. For cancer of the bladder, for example, chemotherapy is placed right into the bladder through a catheter in the urethra. Such a treatment has only a minor effect on a man’s sex life. You may notice some pain if you have sex too soon after the treatment. This is because the bladder and urethra are still irritated.
For more information, please see our document Sexuality for the Man With Cancer.
Sexual changes women may experience
- Many chemotherapy drugs can either temporarily or permanently damage a woman’s ovaries, reducing their output of hormones. This affects a woman’s fertility and libido (sex drive). Ovarian function is less likely to return in women over age 30, and they are also more likely to go into early menopause. (If you would like to read more about preserving fertility, see our document called Fertility and Cancer: What Are My Options?) Symptoms of early menopause include hot flashes, vaginal dryness and tightness during sexual intercourse, and irregular or no menstrual periods. As the lining of the vagina thins, light spotting of blood after intercourse becomes common.
- Even though menstrual cycles may be disrupted or stopped with chemotherapy, it may still be possible to get pregnant at this time. Some chemotherapy drugs may cause birth defects. Because of this, women getting chemotherapy should use a reliable type of birth control if they are sexually active.
- Some chemotherapy drugs irritate all mucous membranes in the body. This includes the lining of the vagina, which often becomes dry and inflamed (a condition called vaginitis).
- Vaginal infections are common during chemotherapy, particularly in women taking steroids or powerful antibiotics used to prevent bacterial infections. You may notice itching, swelling around the vagina, a whitish discharge, or discomfort such as burning during intercourse. If you have any symptoms, tell your doctor. It is very important to have vaginal infections treated. Any infection may become a more serious problem if it is not dealt with quickly.
- If you have had genital herpes or genital wart infections in the past, you may have flare-ups during chemotherapy. This is because chemotherapy suppresses your immune system.
- Chemotherapy is often given through an IV tube into the bloodstream. However, new ways have been developed to bring drugs directly to a cancerous tumor. For cancer of the bladder, for example, chemotherapy is placed right into the bladder through a catheter in the urethra. Such a treatment usually has only a minor effect on a woman’s sex life. You may notice some pain if you have sex too soon after the treatment. This is because the bladder and urethra are still irritated.
For more information, please see our document, Sexuality for the Woman With Cancer.
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