How your sex life is affected will depend on what treatment your having and what parts of your body are affected.
We've outlined some of the common complications below. If you experience any of these effects, you can speak with your treatment team about how you can manage these.
treatment commonly causes fatigue (tiredness that does not go away with rest), which may last for several weeks, months, or even years. The tiredness from having radiation treatment can make you feel less like having sex
Sex after surgery
Any surgery can affect our sex lives, even if it does not involve the sex organs directly.
Surgery can affect your body image and how you think about your body.
For example, some people feel or say that their bodies have “let them down” because they used to feel fit and healthy.
Some people feel like different people and have lost confidence.
Others find they experience sexual sensations even though they have changes to their erections and orgasms. Everyone reacts differently.
How different surgeries can affect sex
Having surgery on the breast can affect sexual arousal in many ways, particularly if you were “turned on” by having your breasts and nipples touched.
Some women say that the operation affects their image of themselves, and they feel less womanly. You may find that you need a lot of time to talk through the feelings and emotions that breast surgery can cause.
For more information on breast reconstruction and breast prosthesis, see our information on breast cancer.
A total hysterectomy is the removal of the uterus (womb) and cervix. Sometimes one or both ovaries are also removed.
Once the uterus is removed, the surgeon stitches up the top end of the vaginal canal. This makes it slightly shorter than it was before.
While healing takes place, you might prefer not to have sex or for your partner to be very gentle. Try different positions to find out which are most comfortable.
A hysterectomy may affect your experience of orgasm, as some of the nerves leading to the clitoris may be affected by the surgery.
Most people find that they can still have orgasms, but the sensations may be different from before the operation. You may need to experiment with touch in different places around the clitoris and use a lubricant to increase sensation.
Some surgeons specialise in doing surgery that is less likely to damage the nerves, known as nerve-sparing surgery.
An abdominoperineal resection is one of several operations used to remove cancer of the colon or anus. This operation can affect the nerves that control erection and ejaculation.
In some cases of low rectal cancer, the anus is removed and closed over permanently. You will have a stoma bag over the opening of the bowel, which will collect the poo (faeces).
Oophorectomy is the name of the operation where your ovaries are removed.
This causes “surgical” menopause, so you will go through symptoms of menopause. It’s likely that you will notice these symptoms occurring more quickly than the gradual onset that occurs with natural menopause.
In many cases, replacement hormones (HRT) can return the body to near normal. You may find it helpful to talk this through with your doctor.
Vulvectomy is where part or all of the vulva is removed.
This is a rare operation that is sometimes necessary for people with cancer of the vulva (the outer part of the female genitals).
Removal of the vulva can affect sensations during sex, especially if the clitoris has had to be removed. This surgery may alter how you view your body and sense of self.
Cystectomy is the removal of the bladder.
This can cause an inability to have an erection as nerves in the penis are cut when the bladder is removed.
Orchidectomy is the name of the operation where one or both testicles are removed.
If only one is removed (usually the case for testicular cancer), this will not cause infertility and does not usually affect your sexual function.
For a short time after the operation, avoid sexual positions that apply pressure to this area. Some men say their orgasms feel different. The amount of ejaculated fluid is usually less than before.
A false testicle (prosthesis) can be inserted into the scrotum, which will give the appearance and feel of a normal testicle. Even though it looks normal, you may feel a change in your body image.
If you have both testicles removed (usually for advanced prostate cancer), you will be infertile and almost always unable to have an erection.
Prostatectomy is the removal of the prostate gland.
Following radical prostatectomy, you will no longer ejaculate semen, so you will have a dry orgasm (no fluid is ejaculated). Talk to your treatment team about sperm banking before treatment if you wish to have biological children in the future.
Some people say this feels totally normal, while others say that their orgasms don’t feel as strong, long-lasting or pleasurable as they did before.
Modern surgical procedures aim not to damage the nerves in this part of the body, but many people will have erection problems.
There may be an erectile dysfunction service in your area. Some specialist services are available through physiotherapists or are attached to urology private practices.
Sex and radiation treatment
Radiation treatment uses radiation beams to destroy cancer cells or slow their growth. It is also called radiation therapy or radiotherapy.
The radiation treatment is carefully planned to affect only the part of the body at which the beams are aimed.
Depending on where the radiation treatment is aimed, it can affect:
- kissing and oral sex because your mouth is dry
- sexual function
- the ability to have or keep erections
Radiation to the head and neck could mean that any oral contact, including kissing and oral sex, is painful as your mouth is dry. Your skin may also feel tender, and you may not want that area touched.
When given to the pelvic area, radiation treatment may affect sexual function for cancers of the prostate, anus, bladder, cervix, ovaries, and uterus.
This will depend on the amount of radiation treatment given. The effects occur because of nerve damage or because blood vessels that supply the penis become scarred and cannot let enough blood through to fill the penis.
The changes can be slow and may worsen during the first year or two following radiation treatment. Many people find there are ways to be sexual without having erections.
Radiation can irritate the urethra that can reduce pleasurable sensation when people with a penis ejaculate. Some feel a sharp pain as they ejaculate, caused by radiation irritating the urethra. This usually disappears within a few weeks after the treatment has ended.
Sex and chemotherapy
Chemotherapy or "chemo" uses drugs to kill cancer cells while doing the least possible damage to normal cells.
Chemotherapy may make you feel tired or sick, and you may not feel like having sex. Your Sex drive will usually return soon after treatment ends.
It's important to know that chemotherapy drugs can affect fertility (your ability to get pregnant or get someone pregnant). Talk to your treatment team before you begin chemotherapy about options to store sperm or eggs for the future.
Chemotherapy can cause the symptoms of early menopause, including hot flushes, irritability, sleep disturbances, achy bones and vaginal dryness. Vaginal thrush is common if you have chemotherapy, especially if you are taking steroids or powerful antibiotics to prevent infection. Your doctor can prescribe treatment for this.
Learning more about the treatments you've been offered can help you prepare.
For many people, having cancer changes how they feel about themselves and how they feel about sex.
We are here to help and support you and your whānau through cancer diagnosis, treatment and recovery…