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 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.
- The American Association of Sexuality Educators, Counselors and Therapists (AASECT) is a professional organization for sexual health experts. They maintain a tool to help people find a sexual health expert near them.
Studies for women
- NCT03180294: Bupropion Hydrochloride in Improving Sexual Desire in Women With Breast or Gynecologic Cancer. This trial studies how well bupropion hydrochloride works in improving sexual desire in women with breast or gynecological cancer. Bupropion is a drug that has been FDA approved to treat depression and may work by boosting sexual desire, energy, or motivation without causing intolerable side effects.
- NCT01788839: Longitudinal Sexual and Reproductive Health Study of Women With Breast Cancer and Lymphoma. The purpose of this study is to see how cancer treatment affects sexual and reproductive function. The patient will also be asked to participate in blood draws to see if and how cancer treatment affects the ovaries and the ability to have children (fertility).
Studies for men
- NCT03525262: Prostate Oncologic Therapy While Ensuring Neurovascular Conservation (POTEN-C) (POTEN-C). Reduction of dose to or 'sparing' of nerves during radiation for localized prostate cancer may improve sexual health without changing cancer outcomes.
- NCT03716739: Improving Quality of Life of Prostate Cancer Survivors With Androgen Deficiency. The goal is to learn if testosterone replacement therapy (TRT) is safe and effective in improving the symptoms of androgen deficiency (sexual symptoms, low energy, and physical dysfunction) and overall health-related quality of life in men with prostate cancer who have undergone radical prostatectomy.
- NCT04049331: Testosterone Replacement in Male Cancer Survivors With Fatigue and Low Testosterone. The overall goal of this study is to evaluate the effect of a testosterone drug called Depo-Testosterone (or 'testosterone cypionate'), an FDA-approved drug for improving fatigue, sexual function, quality of life, body composition, muscle strength, and physical activity in young cancer survivors who report fatigue and have low testosterone. This study is not open to men who have been diagnosed with hormone related cancers, including prostate or breast cancer.
Studies for women or men
- NCT04221607: An Intimacy Intervention for Couples Completing Breast or Prostate Cancer. This project seeks to help patients address and improve intimacy at the end of treatment for breast or prostate cancer