Sexual Activity During Cancer Treatment: Information for Men

This information provides guidance for men on sexual activity during cancer treatment.

Most men can be sexually active throughout their cancer treatment, but it’s important to do so safely. If you have any questions about the information below, speak with your doctor or nurse. 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

It’s important to prevent pregnancy while you’re getting cancer treatment. If you become pregnant with an egg that has been damaged by exposure to radiation, chemotherapy, or other anticancer medications, or if an embryo or fetus is exposed to these treatments during its development, you may have an increased risk for miscarriage or birth defects.

If your partner is a female who could become pregnant, use birth control (contraception) throughout your cancer treatment. Don’t rely on withdrawing before ejaculation (“pulling out”) or on avoiding sex during fertile times of her menstrual cycle (the “rhythm method”). These methods are not effective in preventing pregnancy.

Types of birth control

  • If you have only 1 female partner, you could use condoms. You could also ask your partner to see the healthcare provider (HCP) who manages her gynecologic care to help her select a method of birth control that is best for her. Examples include birth control pills and intrauterine devices (IUDs).
  • If your partner chooses not to use birth control, or if you have more than 1 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 the section “Barrier Devices” for information on buying and using condoms.
  • A vasectomy is a permanent method of birth control for people who are sure that they don’t want any (more) children. This is a minor surgery that is done to block sperm from being released with your semen.

Other considerations

Continue to use birth control for a period after your treatment ends in order to prevent pregnancy.

  • If you’re getting chemotherapy or radiation directed to an area near your testes, continue to use birth control for at least 1 year after your treatment ends. This allows time for damaged sperm to clear from your body.
  • If you’re getting targeted or immunotherapy, the amount of time you should use birth control will vary based on the medication you’re taking. Ask your doctor or nurse how long you should continue to use birth control after treatment.

If you plan to have children after treatment, ask your doctor when it will be safe for you to start trying.

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

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Protect Yourself from Infection

If you or your partner have sex with multiple partners, and you don’t use barrier protection (see the section “Barrier Devices”), you’re at risk for sexually transmitted infections (STIs), including HIV, if you do not use barrier protection. In addition, certain cancer treatments can cause low blood cell counts for long periods of time which may increase your risk of infection. Your doctor or nurse will tell you if this is a concern for you.

To prevent infection:

  • Wash your hands and genitals before and after having vaginal, oral, or anal sex.
  • To protect yourself from STIs (including HIV), consider using a condom 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.
  • If you are expected to have very low blood cell counts for a long period of time, your doctor or nurse may recommend that you use a barrier device during sex, such as condoms or dental dams. See the section “Barrier Devices” for more information.
    • In some situations, your doctor may recommend for you to avoid sex that involves penetration or contact with mucous membranes while your blood counts are low. This includes vaginal, oral, and anal sex or inserting fingers, vibrators, or sex 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’re 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 had stem cell transplant, you are at an increased risk of infection for many months after your treatment. Until your doctor tells you that your immune system has recovered:

  • Use a latex condom each time you have vaginal, oral, or anal sex.
  • Use a condoms or dental dam any time your partner’s saliva, vaginal secretions, or semen could enter your mouth. See the section “Barrier Devices” for more information.
  • Do not perform any sexual activity that could expose your mouth to feces.
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Consider Steps to Avoid Exposing Your Partner to Chemotherapy and Other Anticancer Medications

We don’t know how much anticancer medication gets into a man’s semen or if this poses any risk to a sexual partner. If this is a concern for you or your partner, you may want to use a condom whenever your semen could enter your partner’s vagina, mouth, or anus. This will prevent your partner, regardless age or sex, from being exposed to any medication that may be in your semen.

We don’t know how long these medications may be in semen, but you could use a condom each day you receive anticancer treatment and for 1 week afterward.

Make sure to use condoms throughout treatment if needed for birth control or to protect yourself from infection. See the section “Barrier Devices” for more information.

If your partner is pregnant during your treatment, we don’t know if the medications in your semen would pose any risk to the fetus. Scientific studies on animals suggest this is possible, so we recommend using a condom each time you have sex. See the section “Barrier Devices” for more information.

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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 use 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 because they can cause the condom 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’s too tight or it can fall off if it’s too loose. If this happens while you’re having vaginal sex, your female partner may want to consider taking emergency contraception if she isn’t using another form of birth control. Emergency contraception includes levonorgestrel (Plan B®), also known as the “morning-after pill.”

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, cut off the tip and cut down the side of the tube to make a sheet.
    • You may want to avoid condoms with a spermicide or lubricant, as the taste may be unpleasant.
  • To use a dental dam, have your female partner hold the sheet over her vulva or anus while you are giving her oral sex.
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Resources

Memorial Sloan Kettering (MSK) Male Sexual and Reproductive Medicine Program
646-888-6024

Call for help with issues related to male sexual function.

American Cancer Society

Call 1-800-ACS-2345 to request printed material.

American Congress of Obstetricians and Gynecologists

www.acog.org/patients

New York City Department of Health and Mental Hygiene

Has information on getting and using male and female condoms.

Planned Parenthood

www.plannedparenthood.org

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