A Guide to Chemotherapy

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Sex, fertility, and chemo

Chemo can, but doesn’t always affect sexual organs and how they work. The possible side effects depend on the drugs used, your age, and your overall health.


Chemo may lower the number of sperm cells, reduce their ability to move, or cause other changes. These changes can result in short- or long-term infertility. Infertility makes a man unable to father a child, but it doesn’t affect his ability to have sex.

Because permanent sterility (infertility) may occur, it’s important to discuss this issue with your doctor BEFORE you start chemo. You might want to think about banking your sperm for future use.

Men who are getting chemo should use condoms or other forms of birth control during treatment because chemo may have harmful effects on the chromosomes of sperm cells. Ask your doctor when you can stop using birth control for this reason. You may also need to protect your partner, since some chemo drugs may be in your semen during and just after you get chemo. Ask your doctor about this.


Chemo can damage the ovaries and reduce the amount of hormones they produce. As a result, you may have these side effects:

  • Your menstrual periods may become irregular or stop during treatment. They may – or may not – come back after chemo. In some women, they come back, but menopause may start at a younger age than expected.
  • You may have menopause-like symptoms, such as hot flashes and itching, burning, or dryness of vaginal tissues. These tissue changes can make sex uncomfortable, which can often be relieved by using a water-based vaginal lubricant.
  • You may be more likely to get vaginal infections. To help prevent infection, avoid oil-based lubricants (like petroleum jelly or lotions), always use a condom for sex, wear cotton underwear and pantyhose with a ventilated cotton lining, and don’t wear tight slacks or shorts. Your doctor also may prescribe a vaginal cream or suppository to reduce the chances of infection. If you do get an infection, it should be treated right away.
  • You may become infertile (unable to become pregnant). Whether this happens and how long it lasts depends on many factors, including the type of drug, the doses given, and your age. It’s important to discuss this possibility BEFORE you start treatment.

Pregnancy and chemo

Pregnancy is often possible during chemo, but it should be avoided because some chemo drugs may cause birth defects. Doctors advise women of childbearing age – from the teens through the end of menopause – to use birth control throughout treatment. If a woman is pregnant when her cancer is discovered, it may be possible to delay chemo until after the baby is born. For a woman who needs treatment sooner, the doctor may suggest starting chemo after the 12th week of pregnancy, when the fetus is beyond the stage of greatest risk. In some cases, termination of the pregnancy may be considered.

Talk to your doctor if you and your partner are considering pregnancy after completing chemo. You can also learn more by reading Fertility and Women With Cancer or Fertility and Men With Cancer online. Or you can call us to have a free copy sent to you.

What about my sex life?

Some people feel closer than ever to their partners and have an increased desire for sex during treatment. Some notice little or no change in their sexual desire and energy level. Still others find that their sexual interest declines because of the physical and emotional stresses of cancer and cancer treatment. These stresses may include:

  • Worries about changes in how you look
  • Anxiety about health, family, or finances
  • Side effects, including tiredness and hormone changes

A partner’s concerns or fears also can affect the sexual relationship. Some may worry that physical intimacy will harm the person who has cancer. Others may fear that they might “catch” the cancer or be affected by the drugs.

You and your partner can clear up many of these misunderstandings by talking about sexual concerns with your doctor, nurse, or a counselor. Though you may find it hard to do, talking to a health professional can give you the information and reassurance you need.

You and your partner also should try to share your feelings with one another. If it’s hard for you to talk to each other about sex or cancer, or both, you may want to talk to a counselor who can help you communicate more openly.

If you were comfortable with and enjoyed sex before starting treatment, chances are you’ll still find pleasure in physical intimacy during treatment. But you may find that intimacy takes on new meaning. Hugging, touching, holding, and cuddling may become more important, while sexual intercourse may become less important.

For more information, please see Sexuality for the Woman With Cancer and Sexuality for the Man With Cancer. Call us for free copies of these booklets, or read them online.

Last Medical Review: 06/09/2015
Last Revised: 06/09/2015