Talking about your sex life with your doctors, family, friends or even your partner can be uncomfortable. Whether you have a blood cancer, or love someone who does, you may have questions about how cancer and treatment will affect your sex life. Here are a few frequently un-asked questions about sex and blood cancers.
Can I have sex while on treatment for my cancer?
Unless your doctor tells you otherwise, it is usually okay to have sex while you are on treatment. There are some important things to keep in mind:
- You must use a reliable method of birth control during treatment.
- You must use a condom or other barrier method of protection during intercourse (including oral/ genital sex) for at least three days following chemotherapy. Chemotherapy can be excreted in semen and vaginal secretions, and a condom will help to protect your partner from unnecessary exposure.
- Penetrative sex such as penis to vagina, or penis to rectum should be avoided if you have a compromised immunity. Be creative and find other ways to stimulate yourself and your partner during periods of neutropenia.
My doctors say that my cancer treatment will likely cause infertility. Can I stop using birth control now?
No. Using a reliable method of birth control while you or your partner is undergoing treatment is very important. While therapy may decrease the number of sperm or egg cells released, it is not dependable as a way to prevent pregnancy. Severe toxicity or death of the unborn child can occur if pregnancy occurs during treatment.
How soon can I have sex or masturbate after treatment?
There are no rules or timelines for sex after treatment. Listen to your body (or your partner’s body) and pursue intimacy when you feel ready.
I have a history of sexually transmitted diseases. Will they come back during my treatment?
Genital herpes and warts can reoccur or flare up when your immune system is decreased. If you do not have a regular partner, it is very important to take precautions so that you don’t get any new infections. Using condoms every time for all types of intercourse can help reduce this risk.
I feel so self-conscious about how much weight I have lost during my treatment. Is there anything I can do to get over this?
It is not uncommon for people to feel differently about their bodies after a cancer diagnosis. Weight loss or gain, hair loss, skin toxicity from treatment, even having a central venous catheter in place, can be a painful reminder of your illness. It is natural to feel a sense of loss, or even anger, over these changes.
The most important thing to remember is that you are loved and cared for, not because of how you look but because of who you are. Besides, that body of yours has been through a lot! Here are few things you can try to help you get past your physical changes:
- Talk with your partner, and show any changes before you begin sexual activity.
- Try wearing night wear or clothing items that help minimize the changes to your body.
- If you are looking a bit pale as a result of anemia, try wearing bright colors and makeup to give you a boost.
- Use candles or dim lights during sex if that makes you feel more comfortable.
I feel crazy for even thinking about sex while I am being diagnosed with cancer. How can I talk to my doctor about my sex life when he’s talking about bone marrow?
Difficulties with sex are a side effect just like any other, and sexuality is part of who we all are as human beings. Yes, you might be uncomfortable getting the conversation started. Yes, your doctor might be too. So what? This is your body, your relationships, and your life that goes on when you leave the cancer center. If they can’t speak to you about changes to your sex life, ask for a referral to someone who can, such as a sex counselor or therapist.
It may help to start with a broad question, just to break the ice. In fact, it may make you more comfortable if you don’t use the word “sex” to start out. Here are a few openers:
- What sort of side effects can I expect during intercourse?
- How will my treatment affect my sex life? Or How will treatment affect physical intimacy with my partner?
- Should I be using birth control?
Once you get the conversation started, you will likely feel more comfortable with the topic (after all, the doctor didn’t faint when you asked him, did he?) and you might feel better about moving on to specifics about your situation:
- It burns when I have sex. What can I do about that?
- My erection doesn’t last as long as it used to. Why?
- Will I ever want to have sex again?
If all else fails, you can refer to this article to get the topic going. "I was reading about side effects on this website and I got thinking..."
The Bottom Line
Sex and sexuality is an important part of who we are. Sexual activity, whether by yourself or with a partner, can help raise your mood by releasing pleasure hormones. If you are in a relationship, it can bring you closer together and take your mind off your blood cancer for a little while.
However, it can be a difficult topic to discuss and it may be hard to get the answers you need. There are professionals who specialize in this type of care, and they are available to help you if you ask for them.
Until then, remember that while your sexuality may be an important part of who you are, it is not all of who you are. Take the time to relax and explore your sex life as part of your new life.
Shell, J. Impact of Cancer on Sexuality. In Otto, S. (2001)(ed)Oncology Nursing, 4th ed Mosby: St Louis. (pp.973- 1001).