How cancer can affect sexual health

3 days ago | Angie Murad, Patient Educator | @muradangie

Article written in collaboration with Jennifer Vencill, Ph.D., L.P.

A cancer diagnosis can change many parts of your life. It is understandable that your focus after diagnosis is on surviving cancer. Concerns about sex and intimacy often come up later in treatment, but they should not be overlooked—sexual health is an important part of whole-person care.

Cancer can affect sexuality by changing relationships, emotions, body image, and the body parts involved in sexual functioning. Sexual side effects from cancer treatment are common regardless of gender. It may also be difficult to talk openly about sex with your partner or healthcare provider, but open communication is the first step toward addressing concerns.

My hope in writing this article is to help you feel more comfortable asking questions, exploring new ways of connecting, and seeking support.

Cancer’s Impact on Sexuality

Dr. Jennifer Vencill, Ph.D., L.P., a psychologist and certified sex therapist at Mayo Clinic in Rochester, Minnesota, describes cancer’s impact on sex and sexuality in four main areas:

Arousal – the body’s physical response to sexual stimulation
Desire – the psychological interest in sexual activity (libido)
Orgasmic and ejaculatory function – the ability to reach sexual climax
Pain – discomfort or pain with sexual activity

Arousal

Arousal is the body’s physical response to sexual stimulation. Cancer treatments can change how the body reacts to arousal. Some examples include difficulty with erections, vulvovaginal dryness, loss of elasticity, or thinning of vaginal tissues. These changes can make sexual activity uncomfortable or less pleasurable.

People with a penis may experience erectile dysfunction (ED), where getting or maintaining an erection is difficult. This can result from surgery or radiation that affects the nerves or blood vessels of the pelvic organs (prostate, bladder, colon, rectum).

Desire

Desire, or libido, refers to interest in sexual activity. It is common to experience a lower interest in sex during and after cancer care. Strong emotions such as distress, depression,

or anxiety—as well as fatigue, nausea, and body changes—can make it difficult to relax and enjoy intimacy.

In addition, when one partner takes on a caregiving role, it can shift the relationship dynamic and affect sexual desire for both people.

Orgasmic and Ejaculatory Function

Certain cancers—such as bladder, prostate, rectal, cervical, vaginal, or vulvar—along with their treatments, can cause changes in sensitivity or numbness in sexual organs or other parts of the body. This can make it difficult to reach orgasm or sexual climax.

Pain

Sexual or genital pain and discomfort can occur directly or indirectly because of cancer treatment. Surgery in the pelvic area can cause pain during sex, while hormonal changes from chemotherapy or radiation can also contribute. Fear of pain is another common barrier that can reduce sexual activity.

Understanding how your diagnosis and treatment may affect sexual function across these four areas can help you advocate for yourself and seek appropriate support.

Questions to Ask Your Cancer Care Team

Everyone’s experiences with cancer and treatment are different. Understanding what to expect regarding your body, sex organs, and sexual function can reduce distress and improve well-being.

You don’t have to wait for your provider to bring up the topic — consider asking questions such as:

What kinds of sexual problems might I have because of my cancer?
How might treatment affect my sex life, and what can be done to help?
How will surgery or treatment affect my appearance?
Is it safe to have sex before or after surgery or treatment?
Do I or my partner need to use protection or birth control before, during, or after treatment?
Will I be able to have children after treatment or surgery?

Knowing the answers to these questions can help you and your partner prepare and identify resources early. Your care team can connect you to supportive services and specialists as needed.

Practical Strategies for Adapting and Coping

Dr. Vencill notes that sex may not always return to what it was before cancer, but three words are key to recovery: patience, exploration, and support.

Patience

Healing takes time—both physically and emotionally. It may take time to adjust to a body that looks or feels different. Patience from both partners is essential. Supportive communication, listening to each other’s feelings, and acknowledging challenges can strengthen your connection.

Every couple approaches conversations about sex differently. The more openly you can talk about sexual concerns, the better you can heal and adapt together.

Exploration

Exploring new ways to experience pleasure can help rebuild intimacy. This may include learning new sensations or “body mapping,” a technique often used in sex therapy to rediscover areas of arousal.

Trying new sexual positions can help alleviate pain or may make you feel more comfortable if you are experiencing weakness due to treatment.

You may find it helpful to use sexual aids or devices—first on your own, then with your partner—to enhance comfort and confidence.

Support

Support can take many forms: medical, physical, or emotional. You may benefit from medications, sexual aids, or hormone therapy depending on your treatment and diagnosis.

Pelvic floor physical therapy is an excellent option for many patients. Pelvic floor muscle training can strengthen the muscles in the genital area and improve bladder and bowel control. Once learned, these exercises can be done at home.

If you experience ongoing sexual pain or distress, consider asking for a referral to a counselor who specializes in cancer, sex therapist or pelvic floor therapist who specializes in sexual rehabilitation.

Conclusion

Sexuality is an important part of our well-being, and it deserves attention throughout the cancer experience – not just after treatment ends. While cancer and its treatments can bring physical and emotional challenges that affect intimacy, these changes are not something you have to navigate alone. With open communication, the right information, and caring support from your healthcare team, it is possible to adapt, reconnect, and find meaningful ways to experience closeness again.

By asking questions, exploring new approaches, and seeking help when needed, you can take an active role in your sexual health. Compassion for yourself, patience with the process, and willingness to try new strategies can make a significant difference. Remember that support is available, and you deserve care that honors your whole self—mind, body, and relationships.

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