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Cancer and its treatment can change sexual desire, comfort, sensation and confidence. These concerns are part of health and deserve attention. Practical changes, treatment for symptoms and specialist support can help. You do not have to wait until cancer treatment finishes to raise a concern, and you do not need to be in a relationship to ask.
There is no timetable for returning to sex and no requirement to do so. What matters is what feels comfortable and important to you. Intimacy may mean conversation, affection, touch or sexual activity, depending on your wishes and health.
Why may things feel different?
Fatigue, pain, nausea and anxiety can reduce interest in sex. Changes in appearance, scars, hair loss or a stoma (an opening on the abdomen for body waste) may affect confidence. These changes can matter even when treatment has not involved the reproductive organs.
Some treatments have direct physical effects. Pelvic surgery or radiotherapy may affect nerves, blood vessels or tissues involved in sexual function. Hormone treatments can reduce desire or cause dryness and hot flushes. Chemotherapy can sometimes bring on an early menopause. Erection, ejaculation, orgasm or vaginal comfort may change in different ways.
Tell the team what has changed rather than assuming it must be accepted. If pain, depression or a medicine is contributing, treating that problem may help. Do not stop cancer treatment or another prescribed medicine without discussing alternatives.
How to start a private conversation
You can ask to speak without relatives present, even if someone usually accompanies you. A simple sentence is enough: “Treatment has affected my sex life, and I would like advice.” You do not need to know medical terms.
Try to describe the main difficulty: less desire, pain, dryness, erection changes, fear of injury or worries about how your body looks. Mention when it started and whether it affects you alone, with a partner or both. Ask who can help if the person you are speaking to is not the right specialist.
Care should respect your relationships, sexual orientation and gender identity. Advice should be based on your treatment, body and the activity you want to discuss, rather than assumptions about marriage or what sex means to you. You can choose how much personal information to share.
Rebuilding closeness without pressure
Choose a calm, private time to talk with your partner about intimacy, when neither of you feels under pressure to have sex. Explain what feels comfortable now and what you would like to avoid. A partner may be afraid of hurting you, while you may interpret their hesitation as rejection. A direct conversation can help both of you understand what is happening.
You could choose a time when energy is better, use pillows to support a comfortable position or agree that affection does not need to lead to intercourse. Take breaks and stop if something hurts. These are options to try, not exercises you must complete.
Consent and comfort remain essential. No one should feel obliged to have sex to reassure a partner or prove that recovery is going well. If conversations become difficult, a counsellor or qualified psychosexual therapist can help with communication and adjustment.
Vaginal dryness and discomfort
Dryness can make penetration uncomfortable and may also cause soreness during ordinary activities. A vaginal moisturiser used regularly can help with ongoing dryness; a lubricant is used during sexual activity to reduce friction. They serve different purposes. Choose products intended for this use and stop if they cause irritation.
Water-based or silicone-based lubricants are compatible with latex condoms. Oil-based products can damage latex. Avoid fragranced washes, vaginal douching and products that sting. Persistent pain, discharge, bleeding or urinary symptoms needs assessment rather than repeated self-treatment for presumed dryness.
If non-hormonal measures are not enough, low-dose vaginal oestrogen can sometimes be considered after breast cancer. It mainly treats symptoms in the vagina and nearby tissues, unlike hormone replacement therapy that acts throughout the body. The decision needs an individual discussion because long-term breast-cancer safety is not completely certain.
If you take an aromatase inhibitor, a medicine that lowers oestrogen, involve both your oncologist and gynaecologist.
After pelvic radiotherapy or surgery, vaginal narrowing or problems with the muscles supporting the bladder and bowel may contribute. A trained clinician may recommend vaginal dilators or pelvic-floor physiotherapy. Ask for guidance about timing and technique; do not force stretching or continue through pain.
Erection and ejaculation changes
Difficulty getting or keeping an erection can follow treatment, particularly pelvic surgery, radiotherapy or hormone therapy. It is not necessarily a loss of attraction. Tell the team whether the problem is erection, desire, sensation, ejaculation or a combination, because the options differ.
Treatment may include tablets, a vacuum device, injections or other specialist approaches. The choice depends on the cause, your health and your preferences.
Sildenafil and similar erection medicines need a prescription review: they must not be combined with nitrate medicines for angina or with riociguat, used for certain lung-circulation problems. Ask your team to check all your medicines before you try one.
An orgasm may feel different after treatment, and ejaculation can change or stop after some operations. Erection recovery and fertility are separate questions. If having children matters to you, ask for a fertility discussion as well.
Is sex safe during treatment?
Often some form of intimacy is possible, but advice depends on your treatment and recovery. Ask about restrictions while tissues are healing after surgery or radiotherapy.
If your white blood cells or platelets are very low, or you have infection, soreness or bleeding, ask which sexual activities to avoid temporarily. Follow the advice from your own treatment team.
Cancer cannot be passed to a partner through sex. However, some cancer medicines can be present in semen or vaginal fluids for a period after treatment. The team may advise condoms or other barriers for a specific time. This is a medicine precaution, not a reason to fear ordinary affection.
External-beam radiotherapy does not make you radioactive. Some internal radiation treatments or radioactive medicines have temporary contact precautions. Your radiotherapy or nuclear-medicine team should give the instructions for the actual treatment.
Pregnancy prevention is a separate question
Even if treatment may reduce fertility, pregnancy can still be possible. Ask which contraception is suitable and how long it is required after the last dose. Condoms advised for drug exposure may not be the only contraception needed. The fertility article explains these questions in more detail.
Do not assume that periods stopping, low sexual desire or hormone-suppressing treatment means pregnancy cannot happen. If contraception fails or pregnancy is possible, seek prompt advice because the next steps can be time-sensitive.
Living with a stoma or body changes
If you have a stoma, a stoma nurse can help with practical worries about the pouch, leakage or comfortable positions. Emptying the pouch beforehand or using a cover may help some people feel more at ease. Avoid pressure on healing wounds and ask when particular activities can resume.
You can also ask about comfortable clothing, prostheses or ways to protect sensitive areas. There is no need to hide every change or to show more of your body than you want. A gradual return to comfortable touch may suit you better than trying to recreate everything as it was before treatment.
When to seek help
Arrange a review for ongoing pain, troublesome dryness, erection problems or distress that affects your relationships or quality of life. New genital bleeding, sores, unusual discharge or pain when passing urine should be checked. Seek urgent help for heavy bleeding or severe pain.
During chemotherapy, a temperature of 38°C (100.4°F) or above needs immediate contact with your cancer team; follow a lower threshold if your unit has given one. Do not wait for a fever if you feel suddenly very unwell.
Support may involve a gynaecologist, urologist, pelvic-health physiotherapist, counsellor or sexual-health specialist. Ask for a clear referral rather than assuming that nothing can be done.
Common questions
Is loss of interest permanent?
Not necessarily. It may change as symptoms, hormones and circumstances change. Some difficulties persist and benefit from targeted treatment. There is no need to force sexual activity while waiting.
Can a partner attend the appointment?
Yes, if you want them there. It is also reasonable to speak privately first. Your wishes should guide involvement.
What should I ask the team?
“What is safe with my treatment, what might help this particular symptom, and who can offer specialist support?” Specific questions make it easier to agree a useful next step.
Sources and further reading
- Carter J, et al. Interventions to Address Sexual Problems in People With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Adaptation of Cancer Care Ontario Guideline. Journal of Clinical Oncology. 2018;36(5):492–511. Read source
- Macmillan Cancer Support. Sex and cancer. Authoritative patient information, accessed 15 October 2026. Read source
- Cancer Research UK. How cancer can affect your sexuality and sex life. Authoritative patient information, accessed 15 October 2026. Read source
- American College of Obstetricians and Gynecologists. Treatment of Urogenital Symptoms in Individuals With a History of Estrogen-dependent Breast Cancer: Clinical Consensus. Obstetrics & Gynecology. 2021;138(6):950–960. Read source
- Arring N, Barton DL, Reese JB. Clinical Practice Strategies to Address Sexual Health in Female Cancer Survivors. Journal of Clinical Oncology. 2023;41(31):4927–4936. Read source
- European Medicines Agency. Viagra (sildenafil): EU product information, including the Summary of Product Characteristics. Sections 4.3–4.5. Read source
- OncoLink, Penn Medicine. Low Platelet Count (Thrombocytopenia). Patient information. Read source
- Batur P, et al. Society of Family Planning Committee Statement: Contraceptive considerations for individuals with cancer and cancer survivors part 1 — Key considerations for clinical care. Joint with the Society of Gynecologic Oncology. Contraception. 2025;147:110870. Read source
- National Cancer Institute. Infection and Neutropenia during Cancer Treatment. Read source
Medically reviewed and approved by Dr (Prof) Vijay Agarwal
Professor and Lead Consultant – Medical Oncology
