You may have changes in your sex life after cancer treatment—many people do. About half of women who have had long-term treatment for breast and reproductive organ cancers and more than half of men treated for prostate cancer report long-term sexual problems. Many cancer survivors say they were not prepared for the changes in their sex lives.

Sexual problems after cancer treatment are often caused by changes to your body—from surgery, chemotherapy, or radiation, or by the effects of pain medicine. Sometimes these problems are caused by depression, feelings of guilt about how you got cancer, changes in body image after surgery, and stress between you and your partner.

What types of problems occur? People report four main concerns:

Losing interest in sex. Some may struggle with their body image after treatment. Even thinking about their partners seeing them without clothes is stressful. Others are worn out or in pain, and sex is the last thing on their minds. Chemotherapy and some cancer medicines can also reduce sex drive.

Not being able to have sex as you did before. Some cancer treatments cause changes in sex organs that also change your sex life. Some men can no longer get or keep an erection after treatment for prostate cancer, cancer of the penis, or cancer of the testes. Some treatments can also weaken a man's orgasm or make it dry. Some women find it harder, or even painful, to have sex after cancer treatment. Some cancer treatments, like chemotherapy, surgery, or radiation, can cause these problems; sometimes, there is no clear cause for these problems.

Having menopause symptoms. When women stop getting their periods, they can get hot flashes, dryness or tightness in the vagina, and/or other problems that can affect their desire to have sex.

Losing the ability to have children. Some cancer treatments can cause infertility, making it impossible for cancer survivors to have children. Depending on the type of treatment you had, your sex and age, and the length of time you've been out of treatment, you may still be able to have children.

Getting Help With Sexual Problems From Your Doctor or Nurse

Your doctor may be able to help you deal with these problems, but he or she may not bring up the subject. You may need to "break the ice" yourself. If you think you might have trouble getting started, bring this document with you and show this section to your doctor or nurse.

Often, sexual problems will not get better on their own. To get help with many of these problems, it is important to talk to your doctor. Ask about:

Any medical problem that may be causing changes in your sex life. You may be able to get treatment for the problems you are having. These may include:

Erection problems. Medicines, counseling, finding ways to please yourself, surgery, or other approaches may help.

Vaginal dryness. Dryness or tightness in the vagina, which can be caused by menopause. Ask whether using a water-based lubricant during sex, using vaginal dilators before sex, and/or taking hormones or using a hormone cream are options for you.

Ways you can gain muscle control by doing Kegel exercises. You can help strengthen muscles in your genital area by doing these exercises. Practice by controlling your muscles to stop the flow of urine. You can do these exercises even when you are not urinating. Just tighten and relax the muscles as you sit, stand, or go about your day.

Concerns about having children, and what you can do. Discuss family planning concerns with your doctor. If you are a woman, ask if you still need to use birth control even if you are not getting your period.

Seeing a sex therapist. He or she may be able to help you talk openly about your problems, work through your concerns, and come up with new ways to help you and your partner.

Tips: Feeling Intimate After Treatment

Most people can still enjoy sex and intimacy after cancer treatment, even if they need to make changes. Here are some ideas that have helped other people.

Create a sensual mood. Lighting, music, scent, or a romantic meal for two can help.

Have a "date." If possible, set aside special time for just the two of you.

Touch each other. Kiss, hug, and cuddle even when you cannot have the kind of sex you are used to having.

Change positions. A new position may increase your comfort.

Find other ways to be sexual. For example, you may enjoy feelings in parts of the body that were not touched as often before. Think about ways to give yourself pleasure.

Go slowly at first. If you have painful scars, you may have to get used to having the scar touched little by little.

Ask for more foreplay if you need it. Some women say they need more time for foreplay to relax and get ready for sex. Some men say they need a new type of caress to reach orgasm. Their climax may be stronger if they stop and start a few times when they get close to climax.

Find ways to feel more sensual. Wear pajamas or a nightgown that hides your scar and makes you feel attractive. Think about all the ways you please your partner.

Be positive. Your thoughts can play a big role in your sex life.

Tell your partner about your worries or fears.

Other Health Problems

For some survivors, the long-term effects of cancer and its treatment may be made worse by the effects of aging, or by other health conditions, such as diabetes or heart disease, that you may have had before cancer. Breast cancer survivors who have had surgery may find everyday activities like reaching or stretching painful; health conditions such as arthritis can make these activities even more difficult. Colorectal or prostate cancer survivors may find that the aging process also affects their bowel or bladder control.

It is very important that you tell your doctor about:

• All your health conditions
• All the medicines you are taking for these conditions

Some cancer treatments may cause future health problems. Sometimes these problems don't appear right away; some don't appear until years after treatment.

Ask your doctor:

• Whether your treatment can put you at risk for short-term or long-term problems
• What those problems are
• What you should do to take care of your health

Tags: Cancer

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