What is sexual health?
Sexual health involves your mental, physical, emotional, and social well-being related to sexuality. It includes how your body responds to sex and how your sex organ’s function.
Sexuality refers to the feelings and experiences you have around sex. This includes things like attraction, fantasies, values, and attitudes.
What is sexual activity?
Sex can include any type of touching or intimate activity that helps you and your partner feel good and connected. This might include touching, kissing, foreplay, oral sex, vaginal sex, anal sex, or masturbation.
The Effects of Cancer on your Sex Life
Cancer and its treatment can bring changes to your body. These changes may cause grief or a sense of loss. Some ways your sex life might be affected include:
- Changes to your body, such as the loss of a body part
- Problems with erectile dysfunction (getting or keeping an erection)
- Needing things like medication or lubricants, which may affect how natural or spontaneous sex feels
- Loss of pleasure from intercourse because of pain or discomfort
- Dry mouth or mouth sores
These changes are manageable with the right support. Be gentle with yourself—it’s okay to grieve changes in your body and your sex life.
Body image
Body image is how you see and feel about your body. Cancer treatments can change your appearance, which can affect how you feel about yourself.
Tips for managing changes in body image:
- Be kind to yourself—your body is going through a lot, and you are often your harshest critic.
- Talk to someone you trust about how you are feeling
- Wear clothes or accessories that make you feel confident
- Try self-care activities like going shopping or getting your nails done
- For every negative thought, try to name one thing you like about your body.
- If you are still struggling, consider speaking with a professional
Communicating with your Healthcare Team
Talking about sex can be uncomfortable, but your healthcare team is there to support you in all areas of your care.
Tips:
- Write a list of questions or concerns before your appointment. You can also hand the list to your provider if that's easier.
- Remember, your provider is trained and there to help in all areas of your care.
- If you're not comfortable starting the conversation, a Clinical Nurse Specialist (CNS) in the Adolescent and Young Adult (AYA) program can help communicate your concerns and connect you with helpful services.
Communicating with your partner
Talking openly with your partner is very important.
Tips:
- Try writing down your thoughts first.
- Speak openly with your partner so you can work through any issues that are coming up
- Tell your partner what you want and what feels good or does not feel good.
Impact on People with Ovaries/Vagina
Vaginal stenosis (narrowing of the vaginal opening): This can make it difficult to insert anything into the vagina. It may be caused by radiation therapy to the pelvic area, previous surgery below the belt, or muscle spasms within the wall of the vagina.
Management
You can use vaginal dilators to help slowly stretch the vaginal opening. These are available online or through a pelvic floor physiotherapist. Speak with your healthcare provider for guidance on sizing and selection.
Vaginal dryness:
Cancer treatments such as chemotherapy, radiation or surgery can cause vaginal dryness. This can make sex and pelvic exams uncomfortable and may lead to infections.
Management
The treatment options for vaginal dryness are as follows:
- Vaginal moisturizers (creams, gels, or suppositories) used regularly to maintain moisture.
- Vaginal lubricants (used before sex or using a dilator). Water- or silicone-based lubricants are recommended.
Impact on People with a Penis
Erectile Dysfunction: Erectile dysfunction is when there is troubles getting or maintaining an erection. This can be caused by hormone changes with cancer treatment, radiation to the pelvis, or from surgical interventions.
Management
- Explore new positions with your partner that feel good for both of you.
- Know that orgasm is still possible even with a less firm erection.
- It can be treated with both medications or injections
- It can be temporary or permanent, but it is still important to continue to increase blood flow to the penis.
- A sex therapist can help you explore new ways to be intimate.
Changes in ejaculation:
- Dry ejaculation - when you ejaculate but little or no semen comes out (most often happens after prostate related surgeries).
- Climacturia - when you leak urine when you ejaculate. The amount of urine varies between people (this will not harm your partner as urine is sterile).
Management
- Dry ejaculation is harmless.
- For climacturia, talk openly with your partner, use towels or condoms, and discuss with your partner to reduce anxiety.
Impact on Other Body Parts
Mouth changes
- Mucositis: is when you develop sores inside of your mouth after chemotherapy.
- Dry mouth: Is a dry feeling inside of your mouth, often caused by medications.
Management
- Brush teeth 2–3 times daily with a soft toothbrush and fluoride toothpaste.
- If you’ve had surgery or have sores, use a dampened toothette (unless advised otherwise).
- Use plant-based lip balm regularly.
Hot flashes:
Hot flashes are when you feel hot, sweaty and flushed. Men or women can get hot flashes during cancer treatment.
Management
- Wear layers you can remove easily.
- Carry a washcloth to apply cool water to your face.
- Splash cool water onto your wrists.
- Identify and avoid triggers when possible.
Incontinence:
Incontinence is when there is a loss of control of your bladder or bowels. This can happen due to increased levels of fatigue with cancer treatments.
Management
- Have sex earlier in the day when energy levels are higher.
- Go to the bathroom before sex.
- Practice Kegels to strengthen pelvic muscles.
- Avoid alcohol and caffeine, which can increase urgency.
Low sex drive is the decrease in desire for sex. This is common during and after cancer. It can be caused by fatigue, pain, anxiety, fear, frustration or stress, depression, changes in appearance, and hormone changes.
Management
- Know it’s often temporary and may improve post-treatment.
- Seek help for depression or anxiety from your healthcare team.
- Explore other forms of intimacy—hugging, kissing, touching.
- See a sexuality counselor or therapist specializing in sexual health.
Safe Sex During Cancer Treatment
Safe sex helps prevent:
- Pregnancy
- Infection
- Injury
- Exposure to chemotherapy (Cytotoxic Precautions)
Pregnancy prevention:
- Use birth control to avoid potential harm to an unborn baby.
- Talk to your healthcare team about when it is safe to get pregnant after your cancer treatment.
Infection prevention:
- Use condoms or dental dams for sexual encounters.
- Stick with water- or silicone-based lubricants.
- Open communication with your partner about potential cold sores or sexually transmitted infections (STIs)—avoid contact if there is potential that your sexual partner has an STI.
- Get tested for STIs as soon as possible if you are worried that you have contracted one.
- Avoid sex when your neutrophil count is low.
Injury prevention:
- Use lubricant and try comfortable positions.
- Have open communication with your partner if something feels uncomfortable.
- Have gentle sex.
- Wait for medical clearance after surgery.
- Avoid sex if your platelet count is low.
Exposure to Chemotherapy:
- Chemotherapy can be present in semen for up to 48 hours.
- Use condoms or dental dams during this time to protect your partner.
Expert who can Help
Sex Therapists:
Licensed professionals (psychologists, social workers, or psychiatrists) trained in sexuality and relationships. They help individuals and couples navigate intimacy and emotional challenges.
Pelvic Floor Physiotherapists:
Healthcare providers who assist in strengthening pelvic floor muscles. They can help with incontinence, pain during sex, and other related issues.
For more information visit:
Sex, Intimacy, and Cancer
Sexual Health Considerations for Patients Undergoing Cancer Treatment (YouTube video)
