Sex and Your Cancer Treatment

This information explains how your cancer treatment may affect your sex life.

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About Sex and Your Cancer Treatment

How your cancer treatment affects your sex life depends on the type of cancer you have, the type of treatment you’re getting, and your personal situation. You may experience side effects from cancer treatment that may make it harder for you to have sex, such as trouble getting or keeping an erection (getting hard for sex) or vaginal dryness or tightness. You may also have changes to your body or physical side effects from your cancer treatment that may affect your ability or desire to have sex, such as surgical scars, drainage tubes, hair loss, weakness, pain, or fatigue (feeling more tired than usual). These changes may affect how you feel about yourself or how you relate to your partner(s).

Your cancer treatment may also affect you emotionally and make you feel stressed, anxious, or depressed. This can affect your interest in sex and lessen your enjoyment and pleasure in sexual activities. For information about maintaining sexual health and intimacy during cancer treatment, read our resource Sexual Health and Intimacy.

Whether you’re experiencing physical or emotional changes, you’re not alone. Memorial Sloan Kettering (MSK) has experts dedicated to supporting you and your sexual health during your cancer care. There are medications they can prescribe you to help with erections and help you manage erectile dysfunction (trouble getting or keeping an erection). They can also recommend vaginal moisturizers, lubricants, and dilators that can be helpful. For more information, read the resources Improving Your Vulvovaginal Health and How to Use a Vaginal Dilator.

Talk with your healthcare provider for more information about MSK’s sexual health programs or call to make an appointment:

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Having Sex During Your Cancer Treatment

Certain chemotherapy and immunotherapy medications can be found in your bodily fluids (such as vaginal fluids, semen, and saliva). How much and for how long it stays in your body depends on you and your treatment. While studies show that some medications can be absorbed by other people if they come in contact with your bodily fluids, we don’t know whether or not this could be harmful to your partner.

We recommend using a barrier device (condom or dental dam) during treatment and for a week after each treatment during oral, vaginal, or anal sex to prevent your partner from being exposed to any medication that may be in your bodily fluids.

If your partner is pregnant during your treatment, we don’t know if the medications in your bodily fluids could harm the fetus. Studies on animals show this is possible so we recommend using a barrier device each time you have sex. Talk to your healthcare provider for more information.

It’s important to talk with your healthcare provider about how your cancer treatment may affect your sex life. They may not discuss this with you unless you bring up your questions and concerns. While you may feel uncomfortable, remember that most people in cancer treatment have similar questions. Your healthcare provider may be able to suggest ways to help improve any problems you’re having.

To help guide that conversation, you can ask the following questions:

  • Will my treatment affect my sex life? If so, how?
  • How long will these effects last? Are they short-term, long-term, or permanent?
  • What can I do to manage these effects? Are there any treatments or medications I can take to help?
  • How can I make sure my partner is safe during my cancer treatment?
  • How will my treatment affect my fertility? When will it be safe for me to try to get pregnant?
  • Where can I get more information?
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Preventing Pregnancy

It’s important to prevent pregnancy while you’re getting cancer treatment and for at least 1 year after your treatment is complete. If you or your partner becomes pregnant with an egg or sperm that has been damaged by radiation, chemotherapy, or other medications, there may be an increased risk for miscarriage (when a pregnancy ends on its own) or birth defects.

Being pregnant can also affect the tests and treatments you’re able to have during your cancer treatment so it’s best to avoid pregnancy until your healthcare provider tells you it’s safe to get pregnant.

If you or your partner can become pregnant, use birth control (contraception) throughout your cancer treatment. Don’t rely on “pulling out” (taking your penis out of your partner’s vagina) before ejaculating (when semen comes out of the penis after orgasm) or on avoiding sex during fertile times of the menstrual cycle. These methods aren’t effective in preventing pregnancy.

It’s important to pick a birth control method that’s effective and fits your lifestyle. Hormonal birth control options include the birth control pill, patch, or vaginal ring, an implant placed under the skin of your arm, and hormonal intrauterine devices (IUDs). There is also a nonhormonal copper IUD. Talk to your healthcare provider about the different options and visit one the websites listed at the end of this resource for more information.

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Fertility

If having a biological child is important to you, it’s best to talk to your healthcare provider about your fertility options before treatment. You can also ask your healthcare provider for a referral to MSK’s fertility program. For more information, visit www.mskcc.org/cancer-care/treatments/symptom-management/sexual-health-fertility/fertility

If you plan to have children after treatment, ask your healthcare provider when it will be safe for you to start trying. Some cancer treatments, such as pelvic radiation and certain chemotherapy medications, may affect your fertility (your ability to have a biological child). If you have questions about this, ask your healthcare provider.

Here’s a list of resources for more information:

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Preventing Infection

It’s important to prevent getting an infection during and after your cancer treatment. Some cancer treatments may weaken your immune system and make it harder for your body to fight off infections. There are also certain cancer treatments that can cause low blood cell counts for long periods of time which may increase your risk of infection. Your healthcare provider will tell you if this is a concern for you.

To prevent infection, follow these guidelines when having sex:

  • Urinate (pee) after vaginal, oral, or anal sex.
  • If you have sex with more than 1 person, it’s important to protect yourself from getting a sexually transmitted infection (STI), such as HIV. Use a condom or dental dam each time you have vaginal, oral, or anal sex throughout your treatment.
  • If you use sex toys, wash them with hot soapy water every time you use them. Avoid sharing sex toys, especially if you have sex with more than 1 person.
  • Some cancer treatments may weaken your immune system and make you more likely to get yeast infections. This is also more likely if you’re taking steroids or antibiotics.
    • Symptoms of a yeast infection includes vaginal discharge and itching or itching and irritation under the foreskin of the penis. If you have these symptoms, avoid sex and contact your healthcare provider.
  • Some cancer treatments may lower your blood cell counts for long periods of time, which may increase your risk of infection. If this is a concern for you, your healthcare provider may recommend that you use a condom or dental dam during sex or avoid sex that involves penetration (inserting a body part or object into the body, such as during vaginal, oral, or anal sex) until your counts recover.

Preventing infection after your stem cell transplant

You’re at highest risk of infection within the first year after your transplant. Until your healthcare provider tells you that your immune system has recovered:

  • Use a latex condom or dental dam each time you have vaginal, oral, or anal sex.
  • Use a condom or dental dam any time your partner’s saliva, vaginal secretions, or semen could enter your mouth.
  • Don’t do any sexual activity that could expose your mouth to feces (poop).
  • Avoid sex that involves penetration (anal or vaginal sex) while your blood counts are low (a platelet count less than 50,000). This also includes inserting fingers, vibrators, or other sex toys into your vagina or anus.
  • Avoid sex if you think you or your partner may have a genital infection.

Hugging, cuddling, gentle touching, and kissing skin are other ways you can be intimate with your partner during this time. For more information, read Sexual Health and Intimacy.

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Resources

MSK’s Female Sexual Medicine and Women’s Health Program
www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/sexual-health-fertility/health/female-medicine
646-888-5076
This program helps you manage issues related to your cancer care and sexual health. Call for more information or to make an appointment.

MSK’s Male Sexual and Reproductive Medicine Program
www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/sexual-health-fertility/health/male-medicine
646-888-6024
This program helps you manage issues related to your cancer care and sexual health, including erectile dysfunction. Call for more information or to make an appointment.

MSK’s Fertility Program
www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/sexual-health-fertility/fertility
This program helps you manage issues related to fertility and your cancer treatment. Ask your healthcare provider for a referral to talk with a fertility nurse specialist.

American Cancer Society
Sex and the Man with Cancer
Sex and the Woman with Cancer
www.cancer.org
800-ACS-2345 (800-227-2345)
The ACS offers a variety of information about cancer and sexual health. Call to request printed material.

American Congress of Obstetricians and Gynecologists
www.acog.org/patients
This organization education resources about pregnancy, birth control, and sexual health.

New York City Department of Health and Mental Hygiene
www1.nyc.gov/nyc-resources/service/1428/condom-information
They have information on getting and using male and female condoms.

Planned Parenthood
www.plannedparenthood.org
Planned Parenthood has information about sexual health.

Centers for Disease Control and Prevention (CDC)
www.cdc.gov/reproductivehealth/contraception
www.cdc.gov/std
The CDC has information about birth control, STIs, and other sexual health topics.

Bedsider
www.bedsider.org
Bedsider has information and education about birth control.

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