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Sexual Activity During Cancer Treatment: Information for Men

Sexual activity can provide pleasure and intimacy during your cancer treatment. The information below can serve as a guide to being sexually active during this time.

If you have any questions about this information, let your doctor or nurse know. If you have any concerns about how to follow these suggestions based on your religious observances, we advise you to speak with your religious leader.

Use Birth Control to Prevent Pregnancy

If a woman becomes pregnant with sperm damaged by exposure to radiation, chemotherapy, or other anticancer medications, there is a risk of miscarriage or birth defects. If your partner is a female who could become pregnant, use contraception (birth control) throughout your cancer treatment. Do not rely on withdrawing before ejaculation (“pulling out”) or on avoiding sex during fertile times of her menstrual cycle (“rhythm method”). These are not effective in preventing pregnancy.

There are different types of birth control you can consider.

  • If you have only 1 female partner, ask her to see a gynecologist to help her select a method of birth control that will be successful for her. Examples include birth control pills, intrauterine devices (IUDs), and diaphragms.
  • If your partner chooses not to use birth control, or if you have more than 1 female partner, use a condom each time you have sex. Condoms not only prevent pregnancy, but they also protect you from sexually transmitted infections (STIs), including HIV. See “Barrier Devices” below for information on buying and using condoms.

If you are getting chemotherapy or radiation directed to an area near your testes, continue to use birth control for at least 1 year after your treatment has ended. This allows time for damaged sperm to clear from your body. If you plan to have children after treatment, ask your doctor when it is safe for you to start trying. Depending on your situation, your doctor may recommend you wait more or less time.

Some treatments may affect your fertility (the ability to have a biologic child). If you have questions about this, ask your doctor or nurse.

Protect Yourself from Infection or Bleeding

Patients with multiple partners are at risk for sexually transmitted infections (STIs), including HIV. In addition, certain cancer treatments can cause low blood cell counts for prolonged periods of time, which may increase your risk of infection or bleeding. Your doctor or nurse will let you know if this is a concern for you. To prevent infection or bleeding:

  • Wash your hands and genitals before and after having vaginal, oral, or anal sex.
  • If you have sex with multiple female and/or male partners, consider using a condom each time you have vaginal, oral, or anal sex throughout your treatment to protect yourself from STIs, including HIV.
  • If you are expected to have very low blood cell counts for a prolonged period of time, your doctor or nurse may advise you to use a barrier device during sex—condoms or dental dams. See “Barrier Devices” below for more information.
    • In some situations, you may even be advised to avoid sex that involves penetration or contact with mucous membranes while your counts are low. This includes vaginal, oral, and anal sex or inserting fingers, vibrators, or sexual toys into your anus.
    • Hugging, cuddling, gentle touching, and kissing skin are other ways you can be intimate with your partner during this time.
  • Some men develop yeast infections under the foreskin of the penis during treatment, especially if they are taking steroids or antibiotics. Symptoms include itching, irritation, and discharge from the penis. If you suspect you have a yeast infection, avoid sex and call your doctor or nurse.
  • If you have had a bone marrow or stem cell transplant, you are at increased risk of infection for many months after your treatment. Until your doctor tells you that your immune system has recovered
    • Use latex condoms each time you have vaginal, oral, or anal sex.
    • Use a barrier device (condoms or dental dams) any time your partner's saliva, vaginal secretions, or semen could enter your mouth. See “Barrier Devices” below for more information.
    • Abstain from any sexual activity that could expose your mouth to feces.

Consider Steps to Avoid Exposing Your Partner to Chemotherapy and Other Anticancer Medications

There is little data about how much anticancer medication gets into a man's semen and even less on whether this poses any risk to a sexual partner. If this is a concern to you or your partner, consider using a condom whenever your semen could enter your partner's vagina, mouth, or anus. This will prevent your partner, regardless of his or her age or gender, from being exposed to any medication that may be in your semen. We don't know how long these drugs may be in semen, but you could use a condom each day you have chemotherapy and for 1 week afterward. If you have multiple partners, or if you have a female partner who could become pregnant and is not using any other form of birth control, use condoms throughout your treatment and until your doctor advises you that it is safe to attempt pregnancy. See “Barrier Devices” below for more information.

Barrier Devices

Condoms

  • You can buy condoms at any drug store. We recommend latex condoms, but if you or your partner is allergic to latex, use polyurethane condoms.
  • Spermicides do not provide any added protection.
  • You can use lubricated condoms or a separate water- or silicone-based lubricant.
  • Before you use a condom, check the expiration date on the wrapper. Expired condoms are more likely to break.
  • To use a condom correctly:
  1. Be careful when opening and handling the condom. Don't use your teeth, scissors, or other sharp objects to open the wrapper. Don't use the condom if it is torn, brittle, or stiff.
  2. Wait until your penis becomes firm before putting on the condom.
  3. While pinching the tip of the condom, unroll it over your penis as far as it will go. The extra space at the tip is needed to collect your semen.
  4. Smooth out any air bubbles—they can cause condoms to break.
  5. After you have ejaculated, but before your penis becomes soft, hold the base of the condom (where the ring is) and carefully pull your penis out of your partner so that nothing spills.
  6. Carefully slide off the condom and throw it in the trash.
  • A condom can tear if it is too tight or it can fall off if it is too loose. If this happens while you are having vaginal sex, and your partner is of childbearing age, have her call a gynecologist. She should ask about emergency contraception (the morning-after pill) if she is not using another form of birth control.

Dental Dams

  • A dental dam is a thin, rectangular sheet of latex or silicone that covers the genitals of a woman receiving oral sex.
  • You can buy these online, get them from the New York City Department of Health and Mental Hygiene, or make one out of a condom.
  • If you want to make a dental dam out of a condom, you may want to avoid those with a spermicide or lubricant, as the taste may be unpleasant. Cut off the tip and cut down the side of the tube to make a sheet.
  • To use a dental dam, have your female partner hold the sheet over her vulva or anus while you are giving her oral sex.

Resources

MSKCC Male Sexual and Reproductive Medicine Program
(646) 888-6024
For help with issues related to male sexual function.
 
American Cancer Society: Sexuality for the Man with Cancer
Call 1-800-ACS-2345 to request printed material.
 
American Congress of Obstetricians and Gynecologists
 
National Cancer Institute: Sexuality and Reproductive Issues
Call 1-800-4-CANCER to request printed materials.
 
Planned Parenthood
 
New York City Department of Health and Mental Hygiene
For information on getting and using male and female condoms.