Sex and side effects of cancer treatment

Most people will have some general side effects. These usually get better, but they can affect your sexual well-being for a while.

During and after treatment, you might have less energy. You may need more rest or get tired easily. When you are tired, you may be less interested in sex or even in spending time with people.

If you have a partner, it might help to just spend time being close and intimate without having sex. Sometimes this can lead to sex. But it is also a way to build trust and confidence together.

If you want to have sex or masturbate, choose a comfortable and relaxed position. You may want to plan for a time of day when you have more energy. Do not put pressure on yourself to make it last a long time or to orgasm (come).

We have more information about coping with tiredness.

Some cancer treatments can cause sickness and nausea. These treatments include chemotherapy and radiotherapy given near the tummy area (abdomen) or to the head. Other treatments can also cause sickness. Your cancer team will give you drugs to prevent and manage sickness. Tell your cancer team if you still feel sick. They can help.

Your treatment may only make you feel sick at certain times. For example, chemotherapy is most likely to make you feel sick in the hours or days after you have it. If you can work out when you usually feel sick, you can plan for when you are likely to feel more interested in sex.

We have more information on sickness and nausea.

Any type of pain can make you feel less interested in sex. You might not want to have sex because you feel uncomfortable. Or you might be worried that sex or masturbation will be painful.

It can help to try different things to find what works for you. You may want to do this by yourself or with a partner if you have one. This will help you discover which positions or types of touching feel comfortable for you.

If you have a partner, it can help to talk about how you are feeling. They may not want to have sex if they are worried about hurting you. Try to find a position that feels comfortable and relaxed for you both. Talking can help with any worries you may both have.

If you have pain in the pelvic area, you may want to try types of sexual contact that do not involve penetration. If you want to have vaginal or anal sex, using a lubricant may make things more comfortable. You can choose positions that allow you to control the depth and speed of penetration. Using a silicone penis ring during sex can also help control the depth.

You can also ask your cancer team or GP for advice about painkillers and ways to reduce the pain.

Lymphoedema is swelling caused by a build-up of fluid in the body’s tissues. Sometimes this is caused by cancer or treatments such as surgery or radiotherapy. Depending on the type of cancer, the swelling may affect:

• an arm or leg
• a breast
• an area of the head or neck
• an area of the pelvis, such as the vulva or penis and testicles.

This may affect your sex life or how you feel about your body. If you want to have sex, it may help to:

• try positions that do not put weight on the affected area
• have sex at times when the swelling is less – this might be in the morning, or after you have worn a compression garment for a few hours
• use lots of lubricant to protect the skin if the vulva or penis and testicles are swollen.

We have more information about coping with lymphoedema. You can also get advice from your cancer team, GP or lymphoedema specialist.

Some cancer treatments, such as pelvic radiotherapy or bowel surgery, can cause:

• diarrhoea or loose stools (poo)
• wind
• needing to poo with little or no warning.

These effects may get better after treatment, but sometimes they are a long-term problem. They may make you feel embarrassed about being intimate with someone. They can also make you less interested in sex.

There are often ways to manage bowel problems. Your cancer team can give you medicines or advice about diet changes and exercises that may help. They may refer you to a specialist for treatment or more support.

These tips might help:

• For a few hours before sex, avoid eating foods that make your bowel problems worse.
• Go to the toilet just before you have sex.
• Light scented candles if you are worried about smells.
• Make sure you can get to the toilet quickly and easily.
• Have tissues and towels nearby during sex.
• Try an anal plug. This is a foam tampon you can wear in the back passage. It may be helpful for some people who cannot control when they need to poo. Anal plugs for bowel problems are available through the NHS. Ask your cancer team or GP for advice.

The chest, breasts and nipples are sensitive areas of the body. They may be an important part of your sex life. They can also be important to how you feel about your body and sex.

Surgery for breast cancer can affect the nerves to parts of the chest, breast or nipple. Areas may feel numb or have less feeling than before. Sometimes this improves as you recover, but it may be permanent.

Surgery for breast cancer can also affect how the breast or chest looks. It may change the size or shape. Or it may leave scars.

If you have a whole breast removed, you may choose to have surgery to create a new breast shape. This is called breast reconstruction. The new breast may have less feeling or feel numb. We have more information about breast reconstruction.

Radiotherapy to the breasts or chest area can cause a skin reaction. The treated area may feel swollen, sore or tender until the skin heals. After treatment, the treated skin may permanently look or feel slightly different.

Give yourself time to recover after your treatment. You may want to experiment by yourself or with a partner to find what feels good now. A sex therapist may also be able to help you cope with changes to your body image or sensation issues.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

• use plain English
• explain medical words
• use short sentences
• use illustrations to explain text
• structure the information clearly
• make sure important points are clear.

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.

You can read more about how we produce our information here.