Sex life after bowel cancer
Bowel cancer and its treatment can affect your sex life and how you think and feel about your body. This page is for anyone who has had treatment for colon, rectal or anal cancer.
How bowel cancer can affect your sex life
Being diagnosed with cancer and its treatments and side effects may affect your sex life and how you see yourself (body image).
You may feel too tired to have sex during treatment and for a time afterwards. This often gradually improves after treatment, but for some people it may take longer.
Related pages
Booklets and resources
Changes to your body
If you had an operation, you may have a scar or stoma. If you feel self-conscious about changes to your body, it can also affect your sex life. Talking about your feelings may help reduce your anxiety. If you have a partner, you may both find it takes time to adjust to any changes.
We have more information about body image and concerns.
Sometimes surgery or radiotherapy can cause problems with getting and keeping an erection (erectile dysfunction). Medicines such as sildenafil (Viagra®) can help you get an erection. If you are having erection difficulties, talk to your doctor as soon as possible. The sooner you start treatment, the more effective it is.
Women, and other people assigned female at birth, may find orgasms are less intense than before. This is caused by changes to blood flow and nerves in the pelvic and genital areas. These changes may improve over time but are sometimes permanent.
Radiotherapy to the pelvic area can cause the menopause, which may lower your sex drive. Chemotherapy might also cause the menopause. Your doctor or nurse may prescribe hormone replacement therapy (HRT) to help with menopausal symptoms.
Anal sex after treatment
If you have had pelvic radiotherapy, you may need to be careful with anal sex and anal play. The tissues in the area may be fragile. This can make anal sex uncomfortable.
Surgery to remove the anus means anal sex and anal play are no longer possible.
Coping with sexual difficulties
Many people find it difficult to talk about sexual difficulties because they feel embarrassed. Your doctor or nurse will be used to talking about these issues. Let them know if you are having problems with your sex life. They may be able to give you advice or refer you to a sex therapist or counsellor.
There are organisations, such as COSRT - the College of Sexual and Relationship Therapists, that can give you support. It may also help to share your experience with other people through Macmillan’s Online Community.
Related pages
If you identify as LGBT+
If you identify as LGBTQ+, you may worry about being treated insensitively by your healthcare team. You may have some specific questions. Having your sexual or gender identity acknowledged can help you feel more supported. It also means your healthcare team can give you the right information and advice.
If you want to talk things through, you can call the LGBT Foundation on 03453 30 30 30. They can give you confidential advice and support. Also, our LGBTQ+ and cancer forum offers a safe space to ask questions, share experiences and emotions with others living with cancer.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our bowel cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
National Institute for Health and Care Excellent (NICE). Colorectal cancer. NICE guideline [NG151]. Last update Dec 2021. Available from: www.nice.org.uk/guidance/NG151 [accessed Jan 2023].
Cervantes A, Adam R, Rosello S, et al. Metastatic colorectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Annals of Oncology. 2023 ;34(1):10-32. Available from: www.annalsofoncology.org (accessed Jan 2023).
Dr Paul Ross
Reviewer
Consultant Medical Oncologist
Guy's and St Thomas' NHS Foundation Trust
Date reviewed
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We want our information to be as clear as possible. To do this, we try to:
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We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
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