Sexual Health and Intimacy

Many aspects of cancer treatment or preventive care can impact how people view themselves, their experience of desire, and their ability to engage in sexuality and intimacy. The symptoms and severity of these effects will vary, based on the cancer diagnosis and treatment. Some common challenges are listed below. 

Change in body image, shape and sensation

Treatment or surgery can lead to changes in body shape, image or sensation. These changes can affect our sense of touch, how our body functions and our self-image. This is especially true for breast, colorectal, prostate, ovarian and endometrial cancers. Hair loss from chemotherapy can affect confidence and wellbeing. Some types of prostate cancer treatment may cause enlarged breast tissue, hair thinning, and genital shrinkage. Sometimes these changes are more obvious, and sometime changes such as loss of sensation are less obvious but still distressing.

Genito-urinary symptoms

Genito-urinary symptoms may be caused by decreased hormones. Treatments that either block hormones or intensify menopausal symptoms often also impact sexual health and intimacy. Vaginal dryness is a common and frustrating side effect that can impact capacity for sexual activity as well as vaginal health more generally. Medications are available to treat this symptom. Erectile dysfunction may result from adrogen deprivation therapy used to treat prostate cancer. Medications, such as Viagra and Cialis—known as PDE5i—may be used to improve erectile dysfunction. 

Loss of libido

Libido refers to decreased level of sexual desire. Any treatment or prevention that affects hormone levels?—surgery, hormone therapy, chemotherapy and other interventions—can affect libido in men and women. Menopause?—whether caused by surgery, treatment or normal effects of aging?—can lower libido in women. Other factors,  such as body image, relationship quality, physical health and mood may contribute to libido. 

Emotional distress, anxiety and depression

A diagnosis of cancer or testing positive for an inherited mutation can affect mental health and wellbeing. Read more in our Emotional Wellbeing section. Psychological wellbeing is also related to a positive experience of sexual health and intimacy.  

Improving sexual health and intimacy

Issues of intimacy and sexuality are gaining more attention from the health care providers community and more research is being done to better address them. Despite this, many patients experiencing sexual dysfunction do not receive the care they need. Therefore, it is important for you to tell your doctor if you are experiencing any distressing changes in sexual function and ask about your options for referral to an expert.

Fortunately, there are a growing number of strategies. resources and products available to help improve changes in sexual health, body image and intimacy. Sometimes medications that affect libido, sensation or sexual function can be changed or adjusted. New medication may be prescribed to improve libido or manage side effects, such as vaginal dryness or pain during intercourse. Health care providers trained in couples counseling, intimacy or sexuality may help patients and their partners work through some of these challenges. Some cancer centers now have departments and specialists that focus on long-term quality-of-life issues including intimacy and sexual health.