Sexuality for the Woman With Cancer

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Sex and chemotherapy

Chemotherapy, or chemo, is often given through an intravenous (IV) tube, which sends it through a vein right into the bloodstream. But some methods bring drugs right to a tumor. For cancer of the bladder, for example, the chemo drug is put right into the bladder through a small, soft tube called a catheter. Treatment like this usually only has a minor effect on a woman’s sex life. But she may notice some pain if she has intercourse too soon after the treatment. This is because the bladder and urethra may still be irritated from the drugs.

Women with tumors in the pelvis may get chemo by pelvic infusion. The drugs are put into the arteries that feed the tumor and give an extra-strong dose to the genital area. Since this method is fairly new, doctors do not yet know the long-term effects on a woman’s sex life. Over the short term, the side effects are much like those of IV chemo.

Another way of giving chemo is by intraperitoneal infusion (the drugs are put into the abdomen or belly). For cancers of the ovaries or colon, the space around the intestines may be filled with drugs in liquid form. This extra fluid causes the abdomen to swell a little. The drugs and liquid are then drained back out after a short period of time. The infusion can be somewhat uncomfortable and may feel a bit strange.

It’s very important to ask your chemo doctor or nurse when you can have sex, what precautions you need to take, and how your treatment might affect your sexual function.

Pregnancy and fertility during and after chemo

If you think you might want to have children in the future, it’s important to talk to your doctor about this before starting chemo. You need to know if treatment will affect your fertility. Many chemo drugs can damage the ovaries, reducing their hormone output. Sometimes the ovaries recover after chemo, but sometimes they don’t. To learn more, see our document called Fertility and Women With Cancer (See the “To learn more” section for more information.)

During chemo, women should use birth control to keep from getting pregnant. Ask your doctor what kind of birth control is best and safest for you to use. Many of the drugs used to treat cancer can harm a fetus. If you want to get pregnant, talk with your doctor about how long you should wait after treatment is over.

After chemo, it may still be possible for some women to get pregnant. This is more likely to happen with younger women. Keep in mind that, even if you’re still having monthly periods, it’s hard to say whether you can get pregnant. Women who don’t want to become pregnant should use birth control, even after having chemo.

Early menopause with chemo

Women getting chemo often have symptoms of early menopause. These symptoms include hot flashes, vaginal dryness, vaginal tightness, and irregular or no menstrual periods. If the lining of the vagina thins, there may be a light spotting of blood after penetration.

Other chemo-related problems that may affect your sex life

Some chemo drugs irritate all mucous membranes in the body. This includes the lining of the vagina, which may become dry and inflamed. Yeast infections are common during chemo, especially in women taking steroids or antibiotics to treat or prevent bacterial infections. If you have a yeast infection, you may notice itching inside your vagina or on the vulva. You may also have a thick, whitish discharge, and you may feel some burning during sex.

Chemo can also cause a flare-up of genital herpes or genital warts if a woman has had them in the past. If you have a vaginal infection, see your doctor and have it treated right away. Infections can lead to serious problems because your immune system is probably weakened by chemo.

Yeast infections can often be prevented by not wearing pantyhose, nylon panties, or tight pants. Wear loose clothing and cotton panties to avoid trapping moisture in the vaginal area. Wipe front to back after emptying your bladder and do not douche. Your doctor may also prescribe a vaginal cream or suppository to reduce yeast or other organisms that grow in the vagina. Since your immune system may be weakened, it’s especially important to avoid sexually transmitted diseases. If you are having sex with someone, it’s important to practice safer sex from start to finish (use condoms or other barriers to avoid body fluids). Do this every time you have oral, anal, or vaginal sex. For more information about safer sex, you can contact the American Sexual Health Association (their contact information is in the “To learn more” section).

During sexual intimacy, it’s important to avoid touching the vagina and the urethra with anything that has been used to stroke near the anus. Lingering germs from the bowel can cause infection if they get into these areas.

Chemo and sexual desire

Women who are getting chemo often notice decreased sexual desire. Physical side effects, such as upset stomach, tiredness, and weakness, can leave little energy for relationships. Sexual desire most often returns when a woman feels better. If a woman is getting chemo every 2 or 3 weeks, her sexual interest might only come back a few days before she’s due for her next treatment. After chemo ends, the side effects slowly fade, and sexual desire often returns to previous levels.

Women getting chemo also tend to feel unattractive. Hair loss, weight loss or gain, and sometimes infusion catheters (tubes in the vein for chemo or other drugs that stay in for weeks or months) can make it harder to have a positive sexual image of yourself. Tips to handle these problems are discussed in the section called “Dealing with sexual problems.”

Last Medical Review: 08/29/2013
Last Revised: 08/29/2013