What Happens to Your Sex Life When You're Treated for Cancer

A cancer diagnosis and treatment can affect many aspects of a man’s life, from day-to-day tasks to more personal interactions like intimacy with a partner. After certain treatments like chemotherapy, radiation or surgery, a cancer patient’s body may no longer look or feel as it once did.

Though changes are to be expected, it’s important to recognize the ways a body might respond post-cancer, and how that can affect your sex life. Here are some differences you might notice and ways you can establish new forms of intimacy with your partner.


The Effects of Surgery and Hormonal Changes:
For men, cancer treatments can have direct surgical impacts and delayed hormonal impacts on their sexual health. For example, chemotherapy will affect testosterone-producing cells, which can lead to low testosterone. With these hormonal changes, men can often experience difficulty getting and maintaining an erection and/or lower sexual desire. Typically, men will recover from low testosterone, but this can take many months. Other solutions like medication or penile rehabilitation can be discussed with your doctor.

Radiation can lead to similar issues. When patients receive radiation to the pelvic region, potential side effects include radiation proctitis or radiation cystitis—inflammation of the colon and bladder, respectively. These complications can be painful, and lead to bloody stools, diarrhea, overactive bladder, or blood in the urine.

Men can also experience changes in the sensation of their orgasm post-surgery, especially if it’s related to the prostate region. It’s important to note that all of these effects of cancer treatment can impact the way men respond to or initiate sex post-cancer, and should be discussed with your doctor if they interfere with intimacy.

Additionally, during prostate removal surgery, if there is not a concern for control of advanced cancers, the nerves that transmit the signal for erections may potentially be spared. However, simply manipulating the nerves can cause difficulty with erections that may be somewhat recoverable. Patients who have the nerves spared have a better chance of erectile function recovery.

Body Image Issues:
Like anyone, men aren’t exempt from experiencing body image issues. If cancer surgery requires a colostomy or urostomy bag, many men might feel self-conscious about their partners seeing them that way. If, after surgery, men have erectile dysfunction, they might also feel emasculated because of their inability to “perform” to certain societal standards or in ways that were similar to their pre-cancer relationships.

Remember, bodies can change, and so does psychological perception—these feelings are a normal part of adjusting to post-cancer life.

Lack of Interest and Fatigue:
Of course, some of the most common changes men might experience in regard to their changing sex life is their lack of interest and fatigue associated with low testosterone. During treatment, it is common for the patient to lose interest in sex because of the toll these procedures can have on the body.

For men experiencing low testosterone, my colleagues and I at The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James) recommend waiting until you're done with chemo before thinking about treatment for testosterone. With proper care, it may be reversible.

Solutions That Can Help
Alternate Forms of Intimacy
Remember, intimacy doesn’t always mean intercourse. Think about how other forms of sexual contact are important to relationship dynamics. Although men might feel the tendency to withdraw or might feel inadequate because they can’t get or maintain an erection, negotiating new forms of intimacy with your partner can help the relationship respond to any changes for increased confidence and satisfaction.

Penile Rehabilitation and Therapy
Doctors might debate the efficacy of penile rehabilitation by way of medication (think Viagra or Cialis). However, many agree that treating those with erection problems is crucial to allowing the best quality of life during recovery. Try talking to your doctor about different medication options and how they might fit into your sexual life.

Additionally, there are options with greater strength than pills that primary care doctors might not always be aware of. Penile injection therapy is a process whereby the patient is taught to give themselves an injection that will allow them to get an erection when they desire one.

If other options fail, penile prosthesis or a penile implant is an artificial device placed within the penis to give an erection. The outpatient surgery is safe and relatively quick, and can be another option discussed between you and your doctor.

Talking With a Urologist
Most importantly, if you’re experiencing changes in your post-cancer sex life, you should consult your doctor or urologist about the physical and psychological ways you can adapt your intimate relationships to the new way your body might be functioning. Don’t be afraid to ask to see a specialist who may be better qualified to help you with specific needs.

While adjusting to post-cancer life can be difficult, it is important to recognize the symptoms and ways your body might perform differently in intimate relationships. By having open conversations with your partner and your doctor, you can better navigate any symptoms of cancer treatment and re-establish intimacy.