Can I have sex on cancer treatment?

Is it safe to have sex during cancer treatment?

If it feels ok, and you both want to, then you can normally have sex during cancer treatment.  But there are some things you need to know.

In some cases, having cancer can make sex more difficult, at least for a while. If you’re staying in hospital – or have had to move back home – then it might be hard to find private time.

Medically, it might not be possible. Some symptoms of cancers and treatments can impact on pleasure or how easy you find it to have sex.

The most likely reason is that you feel tired and not in the mood and that is okay! Some days you’ll be too exhausted to think about sex, let alone have it. Emotionally, you might feel low. If your body’s changed, you might be feeling low on self-esteem and confidence in how you look.

If that’s the case, you might want to read more about body image and cancer treatment to learn more about dealing with side effects and to find ways to boost your self-esteem.

Sex during chemotherapy

Having chemotherapy can impact your sex life. Some people can carry on as normal but you may feel tired, sore or anxious. You might just not feel interested in sex. The physical changes caused by chemotherapy may also affect your confidence.

Chemotherapy drugs can lead to early menopause in women which could cause vaginal dryness and a loss of interest in sex. Read more on our menopause page.

There are lots of reasons to use a form of barrier contraception, like condoms, during sex if you’re having chemotherapy. They include:

• Stopping chemicals used in chemotherapy being passed to your partner
• Reducing the risk of sexually transmitted infections (STIs)
• Avoiding pregnancy.

Talk to your partner and find what works best for you. Remember you are more at risk if you catch an STI while you are having chemotherapy. You can find out more about screening for STIs here.

Sex during radiotherapy treatment

Having radiotherapy, especially to your lower abdomen or pelvis area can affect your sex life and fertility.

It could cause pain during ejaculation and difficulty getting an erection. Sperm made during and after radiotherapy could be damaged so it’s important to use contraception.

There could be some stiffening and narrowing of the vagina but there are devices that can prevent this. You may also feel dry or start to have menopause symptoms.

Again, the most important thing is to be honest with your partner and do what feels best for you.

Sex after cancer surgery treatment

If you have had surgery, your body may need time to heal before you have sex.

You may also need time to accept any changes to your body or you might feel self conscious about things like scars.

Surgery can cause pain and if sex hurts, make sure your partner is aware and get some advice. Listen to your body and take your time. Try taking painkillers about half an hour before you have sex to give them time to work.

Sex during hormone therapy

Hormone therapy is usually used as a treatment for prostate or breast cancer. By reducing hormones in the body, the growth of the cancer can be slowed down or stopped.

Without these hormones, you may feel you have less interest in sex and a loss of energy.

You may have trouble getting an erection or experience vaginal discharge or dryness.

Sex with different types of cancer

The type of cancer you have might affect whether you can, or even want to, have sex.

If you have breast cancer, treatments such as radiotherapy and surgery can cause pain and numbness, and make it harder for you to get aroused or orgasm. It may feel painful to be touched. If you have had one or both breasts removed, it might take time to get your body confidence back.

With cervical cancer, it’s a good idea to have a few weeks to heal after treatment before you have sex. If you have radiotherapy, side effects can include vaginal dryness, shortening and narrowing of the vagina and pain when having sex.

You should not have sex for at least six weeks after major surgery for bowel cancer. It should be fine to have sex during chemotherapy and radiotherapy treatments. If you have a stoma, it may take time to feel comfortable with the changes to your body.

What about oral sex?

There is some concern chemotherapy drugs can be found in bodily fluids including saliva and sperm. Doctors suggest using a form of barrier contraception like a condom or dam during oral sex. This reduces the chance of your partner being exposed to chemo drugs.

What about anal sex?

If you have a low red cell count of low platelet count you are more at risk of bleeding and infection. Anal sex increases the risk of bleeding when your counts are low. Your cancer treatment might also lower your immune system making it more important to use barrier forms of contraception like condoms.

Speak to your care team if you are unsure if you should be having sex or not.

Avoid getting pregnant

It is important to avoid getting pregnant while you’re going through treatment.

Some treatments can increase the risk of miscarriage or harm an unborn child.

Chemotherapy drugs may mean sperm and eggs are not formed properly or produced at all.

During sex, you or your partner should use a barrier method of contraception like a condom. This can prevent pregnancy, protect your partner from chemotherapy drugs in your system and help to stop STIs. Contraceptives like the pill may not work during cancer treatment.

Loss of sex drive

Having sex might be the last thing on your mind when you are going through cancer treatment. You could have side effects like low mood or changes to your body which have affected your confidence. You might be feeling tired, low on energy and generally unwell.

The most important thing is to talk to your partner about how you are feeling. You may not want to have sex but may still enjoy kissing and cuddling and feeling close.

If your self esteem is the thing holding you back, you can read our tips on how to boost your body confidence.

Vaginal changes from cancer treatment

Your treatment can affect your vagina in various ways. It can become fragile and may be prone to bleeding and infections. Chemotherapy, surgery to remove both ovaries and radiotherapy to the pelvis can all cause an early menopause. This can lead to a loss of interest in sex.

You may also have vaginal dryness because you are feeling tired and stressed. Lubricants and vaginal moisturisers can help.

Surgery and radiotherapy can cause changes to how your vagina feels inside which may make sex uncomfortable. Make sure you talk to your partner and discuss what feels ok. You may find trying new sexual positions will help.

What if sex is painful?

If it hurts, make sure your partner is aware. Take time out and get some advice. Treatment can make you dry and sore but there are gels and lubricants which can help. You can buy these online, over the counter or get them via your medical team. Other treatments such as surgery can cause pain.

Try taking painkillers about half an hour before you have sex to give them time to work. You could also explore less penetrative positions and use pillows to help support you. Make sure you keep talking to your other half and your hospital team for advice.

What else can I do?

Listen to your body. Take your time and build up to it, or try new positions. If you’re just not feeling it right now, you should not feel any pressure. You can find other ways to be intimate if you’re in a relationship.

Talk to your partner. They should understand what’s going on in your body and your mind. Staying silent about sex, even if it’s a bit awkward, can cause more problems long term. Your partner might get the wrong end of the stick and could assume you don’t want sex when you do, or might be concerned you don’t find them physically attractive. You might need reassurance too.

Talk to someone else. The team looking after you at the hospital is there to help, and there’s nothing they won’t have heard before. It might feel awkward at first but they are there for you and your wellbeing.

If you’re feeling down about yourself, read our tips on how to boost your body confidence.