Many patients don’t want to talk about sexual health while being treated for cancer — here’s why they should.

Story by: Sara Thompson on November 18, 2020

Changes in sexual health may not be top of mind when you’ve been diagnosed with cancer, but it might be more important than you expect. It’s important to talk to your health care providers about sexual health and cancer.

Cancer treatment and sexual health

Depending on the treatment you are given, sexual side effects range from mildly annoying to downright debilitating. For instance, hormone-blocking medications can cause vaginal dryness, which can lead to painful sex or lowered sex drive. Patients who have mastectomy (breast removal) may no longer have feeling in the chest area. Changes in body image affect sexual well-being. Young women may face infertility or early menopause with cancer treatments.

“This topic isn’t discussed enough,” said Laila S. Agrawal, M.D., medical oncologist with Norton Cancer Institute. “But sexual health affects your quality of life, and there are ways to address those issues.”

You’re not alone

Patients tend to feel their cancer diagnosis sets them apart from others. They may feel like their issues are theirs alone, but they’re not.

“Sexual health concerns are common issues for cancer survivors,” Dr. Agrawal said. “A Livestrong survey in 2010 listed this as the third most important issue for cancer survivors.”

Many times, patients also feel they shouldn’t discuss their sexual issues with their doctor. Patients may feel uncomfortable asking, or they may be afraid to make their doctors uncomfortable. They may believe sexual health issues are not as “important” as their physical cancer treatments and therefore may be reluctant to bring it up with the doctor.

Practical tips for today

Dr. Agrawal has some ideas to help you open the lines of communication with your doctor, care team and partner.

“It is understandable that this may a sensitive topic to discuss with your doctor,” she said. “Just know that this is a very common issue among cancer survivors, and medical treatments are available that may help.”

It may help to write down your questions before you see your doctor. Here are some questions to get you started.

• Is there a risk of infertility with this treatment? What can I do about it?
• Is it safe to have sex while I am going through chemotherapy? What precautions do we need to take?
• Is it possible to get pregnant while on this treatment? Would there be any increased risks or negative effects on the baby?
• What method to prevent pregnancy would be right for me?
• Will this treatment have effects on sexual function?
• Can anything be done about low interest in sex?
• Can anything be done to help with my body image?
• Sex has become painful. Is there anything that can help?
• What is pelvic floor physical therapy, and would it be helpful for me?

Further resources

“In the near future, we hope to open a sexual health clinic at Norton Healthcare for a more comprehensive assessment and treatment program,” Dr. Agrawal said. “The behavioral oncology program can assist with issues that affect sexual functioning, including body image, libido, depression, anxiety and relationship concerns. Some conditions must be checked and treated by a gynecologist.”

Many sexual health concerns after cancer are very common and can be treated. Just like many things are not the same after a cancer diagnosis, your sex life may not be the same either. Having patience with yourself, having honest communication with your partner and looking at intimacy in new and creative ways can help restore a healthy sex life.