Sexuality for the Woman With Cancer

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Special aspects of some cancer treatments

Urostomy, colostomy, or iIeostomy

An ostomy is a surgical opening created to help with a body function. The opening itself is called a stoma. A urostomy takes urine through a new passage and sends it out through a stoma on the abdomen (belly). A colostomy and ileostomy are both stomas on the abdomen for getting rid of body waste (stool). In an ileostomy, the opening is made with the part of the small intestine called the ileum. A colostomy is made with a part of the colon.

You can reduce the effect of these ostomies on your sex life if you take some common-sense steps. First, make sure the appliance (pouch system) fits like it’s supposed to. Check the seal and empty your pouch before sex. This will reduce the chance of a major leak. If it does leak, be ready to jump into the shower with your partner and then try again.

A nice pouch cover can help make an appliance look less “medical.” Patterns or ready-made covers are available from your enterostomal therapist or ostomy supply dealer.

Another choice is to wear a special small-sized ostomy pouch during sexual activity. Or, if you have a 2-piece system, turn the pouch around on the faceplate. Then the emptying valve is to the side. If you wear an elastic support belt on your faceplate, tuck the empty pouch into the belt during sex. Or you can wear a wide sash around your waist to keep the pouch out of the way. Another way of keeping the pouch from flapping is to tape it to your body. You may also find that you feel more comfortable wearing something like a short teddy or T-shirt to cover your appliance.

To reduce rubbing against the appliance, choose positions for sexual activity that keep your partner’s weight off the ostomy. If you have an ostomy but like to be on the bottom during intercourse, try putting a small pillow above your ostomy faceplate. Then, your partner can lie on the pillow rather than on the appliance.

You can get more detailed information on your type of ostomy in our separate documents called Urostomy: A Guide, Ileostomy: A Guide, and Colostomy: A Guide. (See the “To learn more” section for more information.)


Laryngectomy is surgery that removes the voice box. It leaves you without the normal means of speech, and you breathe through a stoma in your neck. (A stoma is an opening that is made during surgery to help with a body function.) Since the air you breathe can’t be purified by the nose’s natural filter, a special type of stoma cover is needed. Besides catching dust and particles, the stoma cover hides the mucus that leaks out of the stoma. A scarf, necklace, or turtleneck can look attractive and hide the stoma cover. Even during sexual activity, a stoma cover may look more appealing than a bare stoma.

During sexual activity, a partner may be startled at first by breath that hits at a strange spot. On the positive side, one patient quipped, “Now when I kiss, I never have to come up for air!”

You can lessen odors from the stoma by avoiding garlic or spicy foods and by wearing cologne or perfume.

Sometimes problems in speaking can interfere with communication between couples. If you’ve learned to speak using your esophagus, talking during lovemaking is not a big problem. It does take more effort though, and you lose some of the emotional nuances. A speech aid built into the stoma might also work well. But neither method lets you whisper in your partner’s ear. If you use a hand-held speech aid, communication during sex is likely to be awkward and distracting. Still, you can say a great deal by guiding your partner’s hand or using body language.

Talking is not needed in many sexual situations. With a new partner, you may want to talk about the kinds of touching and positions you like before you start making love. You may also want to pre-select ways of signaling important messages you may want to share during sex.

Treatment for head and neck cancer

Some cancers of the head and neck are treated by removing part of the bone structure of the face. Because these scars are so visible, they can be devastating to your self-image. Surgery on the jaw, palate, or tongue can also change the way you talk. Recent advances in facial replacement devices, tissue grafting, and plastic surgery now let many people look more normal and speak more clearly. Ears and noses can even be made out of plastic, tinted to match the skin, and attached to the face. All of these things can be a great help to a person’s appearance and self-esteem.

Limb amputation

Treatment for some cancers can include surgically removing (amputating) a limb. Amputations may call for some changes in lovemaking. A patient who has lost an arm or leg may wonder, for example, whether to wear the artificial limb (prosthesis) during sex.

The answer depends on the couple. Sometimes the prosthesis helps with positioning and ease of movement. But the straps that attach it can get in the way. Without the prosthesis, the partner with an amputation may have trouble staying level during sex. Pillows can be used for support.

Amputations may create ongoing pain or pain where the limb used to be (this is called phantom limb pain). These side effects can interfere with sexual desire and distract a person during sexual activity. If this is a problem, talk to your doctor about how to better control your pain.

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