Chemo and Hormone Therapy Can Affect a Woman’s Sex Life

How chemotherapy can affect sex

Chemotherapy, or chemo, is often given through an intravenous (IV) tube, which sends it through a vein right into the bloodstream. But sometimes the drugs are sent right to the 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 sex too soon after 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. In this case, 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.

Another way of giving chemo is by intraperitoneal infusion – the drugs are put into the space around the organs in the belly. This extra fluid causes the abdomen (belly) to swell. The drugs and liquid are then drained back out after a short period of time.

It’s very important to ask your doctor or nurse when you can have sex and what precautions you need to take while getting chemo.

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 cancer care team about this before starting chemo. You need to know if treatment will affect your fertility. Many chemo drugs can damage the ovaries. Sometimes the ovaries recover after chemo, but sometimes they don’t. See Fertility and Women With Cancer 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 sex.

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.

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 provider may also prescribe a vaginal cream or suppository to reduce yeast or other organisms that grow in the vagina.

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, tell your team and have it treated right away. Infections can lead to serious problems because your immune system is probably weakened by chemo.

Because your immune system may be weak, 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.

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, decreased appetite, and weakness, can leave little energy for sex. 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 central venous catheters (tubes in the vein 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 Treating Sexual Problems for Women With Cancer.

How hormone therapy can affect sex

Hormone therapy may be used to treat cancers of the breast and the lining of the uterus (endometrial cancer). This treatment starves the cancer cells of the hormones they need to grow.

This can be done using drugs. For example, tamoxifen keeps breast cancer cells from using estrogen. Other drugs – exemestane, anastrozole, and letrozole – keep testosterone from being changed into estrogen.

Some women have their ovaries removed or have their ovaries treated with radiation to make them stop working. This is another way to get rid of the hormones a cancer needs to grow.

Any of these treatments will most likely cause symptoms of menopause. These include hot flashes, menstrual cycle changes, and vaginal dryness. In spite of these changes, a woman should still be able to feel sexual desire and reach orgasm. 

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: January 12, 2017 Last Revised: January 12, 2017

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