Cancer and its treatments can cause changes in your body. These changes may make you uncomfortable or decrease your interest in sexual activity. These feelings can make it hard to be intimate with someone.

You may have some questions about how your sexuality or intimacy might change during cancer, treatment and survivorship. The questions you have will be influenced by your age, environment, health, relationships and cultural beliefs. The resources on this webpage aim to help you navigate sexuality and intimacy after a cancer diagnosis.

Sexuality

Sexuality is about how you feel about your body, sexual feelings, thoughts, attractions and behaviours towards other people.

Intimacy

Intimacy is about being close to someone both physically and emotionally. It involves giving and receiving love, showing that you care about someone and that they care about you. It is about feeling valued and supported by each other.

Cancer and its treatments can affect sexuality and intimacy

Cancer and its treatments like surgery, chemotherapy, or radiation can change how your body looks, feels, or works. No matter your gender or sexual orientation, you are likely to experience some changes. Seek support, ask questions and communicate.

Some changes you might experience:

Physical changes

• You might feel tired, have pain, or notice changes in how your body looks or functions.
• Some treatments can affect your hormones, which may lower your interest in sex.

Emotional changes

• Feeling stressed, anxious, or sad is common after a cancer diagnosis.
• These feelings can make it harder to feel close to others or interested in sex.

Relationship changes

• You and your partner may feel unsure about how to act or talk about what’s happening.
• It can be hard to know what the other person needs, especially if you’re both feeling emotional.

Body image

• You may feel different about how you look or feel after treatment.
• This can affect your confidence and how comfortable you feel being intimate.

Watch the webinar Sex, Intimacy & Blood Cancer to hear Dr Amanda Hordern talk about:

• Understanding sexuality and intimacy
• Effects of aging and treatment
• Communication with loved ones and healthcare teams
• Practical coping strategies

Chemotherapy and sexual health

Effects on your body

• Chemotherapy can weaken your immune system, which makes it easier for you to get infections.
• Chemotherapy can lower your platelets, increasing your risk of bruising or bleeding.
• Chemotherapy causes side effects that can impact your desire for sex.

Using protection

• Chemotherapy drugs can be present in your bodily fluids (like semen or vaginal fluids) for 7 days after treatment.
• Use a barrier protection during sex, like condoms.
• This helps protect your partner from being exposed to chemotherapy.
• It is recommended that you or your partner do not become pregnant whilst having chemotherapy and for some time after.

Timing matters

• You might feel too tired or unwell to have sex during certain parts of your treatment.
• Let your partner know how you are feeling and what you want, or don’t want.
• Spend time with each other being intimate, this could be emotional or physical.

Communicate with your partner during treatment

• Talk openly with your partner about any concerns you both may have.
• Be patient with yourself and each other.
• Your physical and emotional needs may change during treatment.

Radiotherapy and sexual health

Radiotherapy can impact sexuality leading to both physical and emotional changes. Symptoms will differ depending on where you had radiotherapy on your body you. Males and females will experience different changes.

Males may experience:

• Erectile dysfunction because of damage to blood vessels and nerves needed for erections.
• Painful ejaculation because of inflammation.
• Reduced sperm production if you have had radiation to the testes.
• Impact on libido because of tiredness, illness and the emotional strain of the treatment.

Females may experience:

• Vaginal dryness due to radiation around that area.
• Painful intercourse because of dryness and inflammation caused by the radiotherapy.
• Changes in libido because of the emotional impact of cancer and its treatment.
• Premature menopause because radiotherapy to the pelvis can affect the ovaries.

Tips for maintaining sexuality and intimacy

Sexuality and intimacy after cancer may be different, but it can still be meaningful and fulfilling. With patience, honesty, and support, you can rebuild connection and confidence. These are some tips to maintain your sexuality and intimacy after a cancer diagnosis.

• Share your feelings with your partner.
• You could plan when to have sex so you can look forward to it.
• Give yourself time to adjust and remember that you still deserve love and comfort.
• Communicate changes and challenges early.
• Don’t assume they know what you’re thinking, ask them how they feel, too.
• Spend time talking and actively listening.
• Show love in other ways, like holding hands, giving a hug, or offering a massage.
• Talk to your doctor or nurse about how treatment may affect your body and sex life.

Who can help?

• Sexual Health Service at Olivia Newton John Cancer Centre in Melbourne. A GP referral is required.
• Men’s Health Collective makes it easy for men to get help with sexual and bladder health. They offer education and treatment based on the best and most up-to-date medical advice.
• Relationships Australia offers relationship counselling as well as a range of specialist counselling services.
• Sexual Health Australia offers Sex Therapy, Relationship Counselling, and Marriage Counselling to individuals and couples with sexual problems, intimacy issues, and relationship difficulties.
• ‘Being Ok…Being You’ is a guide developed by Peter MacCallum Cancer Centre for young people who have cancer and identify as LGBTQIA+. The guide has strategies and tools to help you navigate your cancer care.
• Canteen are a not-for-profit organisation that supports people 12-25 years old. They can provide information and services for young people experiencing changes in sexuality and intimacy while navigating cancer.

Talk with a professional

• Your doctor can explain how treatment may affect your body and what to expect.
• Your specialist nurse may have helpful advice and can guide you to the right resources.
• Psychologists who specialise in sexual health or cancer support.
• Sexual therapists are trained to help with sexual concerns.
• Social workers can connect you with support groups or counselling services.

Keep your doctor informed about any changes you notice in your body or sexual health during treatment. They can offer guidance to help you, and your partner maintain a healthy and safe sexual relationship.

Questions

Can sexual activity worsen cancer?
No, it will not make the cancer worse or cause it to return.

What if I don’t have a partner?
Focus on self-care. You can still explore your sexuality and intimacy in ways that are comfortable to you.

Do I have to be gentle?
It’s a good idea. Penetrative sex can cause penile and vaginal abrasions, which can become infected. Depending on what is happening with your disease and treatment, you could be at a high risk for infection.

I recently had a transplant. When is it safe to start having sex again?
Everyone heals at a different pace. Your doctor knows your situation best and can tell you when it’s safe to start having sex again. Remember, there are other ways to be intimate with your partner.

How can we reduce anxiety?
Deep breathing, listening to calming music, or doing something creative can help calm your mind. Try these before or during intimate moments to help you stay relaxed.

Will treatment affect my fertility?
Yes, some cancer treatment can cause temporary or permanent infertility. Make sure you discuss your fertility concerns with your doctor.