Questions Women Have About Cancer, Sex, and Getting Professional Help

Frequently asked questions about sex and cancer

Can sex during treatment be harmful to a patient or partner?

A few chemotherapy drugs can be present in small amounts in vaginal fluids. You may want to use condoms while you’re getting chemotherapy and for about 2 weeks afterward. Some types of radiation treatment require special precautions for a certain amount of time, too. Talk to your doctor or nurse if you have questions or concerns.

Keep in mind that some cancer treatments may cause harm to the fetus if you get pregnant, and precautions must be taken to be sure this doesn’t happen. Talk with your cancer care team about what kind of birth control is best for you, and how long you’ll need to use it after treatment.

When should a person with cancer not have sex?

Ask your cancer care team if sexual activity may be a problem at any time during or after your treatment. Here are some general guidelines:

  • When recovering from surgery, sex can cause bleeding or strain the cut (incision). Sex may also increase your chance of infection. The time between your surgery and when it’s safe for sex varies. It depends on the type of operation and how well you are healing. Your surgeon can tell you when it’s safe to try sexual activity.
  • Some types of cancer, like cancer of the cervix or bladder, may cause bleeding in the genital area or urinary tract. If bleeding is worse after sex, talk with your cancer care team about it. You may need to wait until the bleeding has stopped and the area has healed.
  • During chemotherapy, a person with an infusion catheter sometimes worries that sexual activity will harm it. As long as you take care not to rub against the dressing, sex should not cause any problems.
  • When you’re being treated for cancer, there are often times when your immune system isn’t working as well as it should. At these times, it may be easier for you to get all kinds of infections. Again, ask your cancer care team if sexual contact poses too much of a threat for infection. Most providers say that if you’re well enough to be out in public, you’re well enough to have sex. If you’re in the hospital because of weak immunity, ask your team’s advice on kissing, cuddling, or sexual touching.
  • There are things you can do to try to prevent urinary tract infections. Some of the bacteria that can start an infection in the urinary tract or genital area can be washed away by urinating a few minutes after sex. Some providers also suggest washing the genital area before sex and drinking extra fluids. If you have urinary tract infections often, you may be given antibiotics to take after sex. This can help prevent infection.
  • If you notice any sores, bumps, or warts on your partner’s genitals or a white or greenish-gray fluid (other than semen) in the opening at the tip the penis, you should find out the cause and then decide if it’s safe to have sex.
  • You can greatly reduce your chances of getting a sexually transmitted disease (STD) if your male partner wears a condom from start to finish each time you have sex. For women with female partners, plastic film or dental dams can be used for oral sex.
  • The sperm-killing chemicals in contraceptives were once thought helpful in fighting bacteria and some viruses. But some studies showed a higher risk of getting HIV infection in women who used nonoxynol-9 (N-9), a popular ingredient in foam and gel contraceptives. Some lubricated condoms also have N-9, so you may want to check the label before you use them. If your vagina is irritated or dry, contraceptive foams, jellies, or films may make the problem worse and cause pain. Water-based lubricants or vaginal moisturizers may be used to help with dryness. (See “Vaginal dryness” in Treating Sexual Problems for Women With Cancer.) Talk with your cancer care team about what methods might best meet your needs for preventing STDs or pregnancy.

Other questions

You probably have many other questions that haven’t been addressed here. Don’t be afraid or embarrassed to discuss them with your doctor or other members of your cancer care team. Write them down now so you’ll remember to ask them at your next visit.

The Foundation for Women’s Cancer Provides a free booklet called “Renewing Intimacy & Sexuality After Gynecologic Cancer” which answers many common questions women have. They also have a “Sisterhood of Survivorship” section aimed at creating an online sharing community for women with cancer.

Getting professional help

The first step in finding help for a sexual problem is to discuss it with your cancer care team.

Many women feel uncomfortable talking to a male doctor about sex or other female problems that may be linked to cancer or cancer treatment. Remember that your doctor is a professional and knows that certain treatments and drugs can change a patient’s sex life. If you are still uncomfortable, another option is to tell a female member of your team, like a nurse, about your concerns so they can relay the message to the doctor.

Many providers are prepared to discuss these topics, but they may assume everything is fine unless you let them know. Many cancer centers have sexual health programs where trained health care providers can help women with any concerns about how cancer treatment will affect their sexual function.

If your cancer specialist can’t help you, you should be examined by a gynecologist. This is a medical doctor trained in diseases of the female genitals and reproductive organs. When the most likely cause of a sexual problem is a hormone imbalance, an endocrinologist might be consulted. (Endocrinologists are experts in the complex cycles and systems that control hormone levels.) Your cancer doctor should be able to tell you if the special knowledge of an endocrinologist is needed.

If your cancer care team is not able to help you, they should be able and willing to refer you for help. There are many different programs and specialists who can help you find the answers you need.

If your partner doesn’t want to go with you to counseling, the health care specialist you see may be able to help you involve your partner.

Sexual rehabilitation programs in cancer centers

A center that specializes in treating cancer may have experts on staff who can assess and treat sexual problems. But these specialists may only see patients who are being treated for cancer at their hospital. If you’re being treated at a cancer center, check to see what programs are offered.

Sexual medicine clinics or sexual health clinics

In recent years, medical clinics and even private practice groups have begun treating sexual problems and/or promoting sexual health. Such clinics provide psychological and medical exams through many different types of health care providers. Some clinics require both sexual partners to take part in the evaluation, though you may be seen alone if you’re not in a committed relationship. You can try calling a nearby medical school and ask if they have a sexual medicine clinic or sexual health program.

Sex therapists

Sex therapy is a brief type of psychotherapy or counseling (about 10 to 20 sessions) focused on solving a sexual problem. Sex therapists believe that sexual skills are learned and that bad habits can be corrected by learning different sexual techniques. In between meetings with the therapist, a couple (or sometimes just one partner) is given homework assignments. The homework includes exercises to help you communicate and enjoy touching more. It also helps reduce the anxiety that often interferes with good sex.

Sex therapists may practice in a clinic or alone. Most states have no laws regulating the title “sex therapist,” so people with no formal training can call themselves sex therapists. But a sex therapist should be a mental health professional (psychiatrist, social worker, or psychologist) with special training in treating sexual problems with sex therapy. Some counselors may provide sexual counseling if a licensed professional supervises them.

It’s not always easy to find a well-trained sex therapist. It’s even harder if you live far from the nearest city.

Professional societies can often give you information about their members in your area who have special training in sex therapy. These are good places to start:

American Association of Sex Educators, Counselors, and Therapists (AASECT)
www.aasect.org

National Association of Social Workers (NASW)
www.helpstartshere.org

You can also get a listing of professionals in your area by contacting your state’s psychological association or a state association for licensed marriage and family therapists.

Other kinds of counseling

Sex therapy is not the only kind of counseling that can be helpful to a person with cancer. Psychotherapy can help you feel better about the changes in your body, help you and your partner communicate more clearly, and give you skills to better cope with cancer and cancer treatment. Finding a well-qualified mental health professional is important.

A psychiatrist has a medical degree with a specialty in psychiatry. They should also be certified by the American Board of Psychiatry and Neurology.

Most psychologists practicing alone have a doctorate in psychology (PsyD) or in education (EdD). Psychologists do not have medical degrees and can’t write prescriptions. Psychologists with a master’s degree are most often supervised by one with a doctorate. In most states, a psychologist must be licensed. Those who practice usually have their degree in clinical or counseling psychology.

Social workers usually have a master’s degree in social work (MSW). Some states have a category for licensed psychotherapists called marriage and family counselors. They usually have a master’s degree in psychology or a related field, plus training in counseling.

Psychiatric clinical nurse specialists or psychiatric nurse practitioners have a master’s degree in psychiatric nursing. They are licensed professionally, but their ability to prescribe medicines varies from state to state.

The cost of counseling varies with the professional’s training. One way to get quality treatment for a lower fee is to find a nearby medical school with a psychiatry clinic. You can also go to a university that trains clinical psychologists and has a psychology clinic. You’ll be seen by a student in advanced training, but they will be supervised by a senior professional.

What to avoid

Men and women often seek help for a sexual problem by going to someone who’s not really a health care provider. Sexual problems are common and upsetting, and many people will try unproven remedies or cures. Although there’s no evidence that any of the following can cure a sexual problem, they are often said to be cures: potency pills (such as “poppers” or “Spanish fly”), oysters, “exercisers” that fit inside a woman’s vagina, hypnotism by someone not trained as a mental health professional, or visits to an independent “sexual surrogate.” These treatments do not work and can sometimes be harmful. Talk to someone on your cancer care team about any treatment you’re thinking about trying before you try it.

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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