Many patients are surprised at the effect that cancers like leukemia, lymphoma, or myeloma would have on their sex life. After all, there is no major disfiguring surgery or amputation, so why would your sex life need to change? The answer is that undergoing chemotherapy, radiation, or stem cell transplant for a blood cancer can be just as devastating as surgery.
There are a number of factors that can affect your desire for sex, and your response to physical intimacy.
The Effect of Blood Cancers on Your Sex Life
The effect that leukemia, lymphoma, or myeloma has on your bone marrow can create some limitations in sex. A low red blood cell count, or anemia, may make you more tired than usual or make you become short of breath easily. Cancer-related fatigue can aggravate these symptoms. It is hard to think about having sex when all you can think about is having a nap!
You may also be worried about bleeding problems due to low platelets, or concerned about infection when your white cell counts are low. For women, a decreased immune system can increase your risk of developing a vaginal yeast infection, which inflames your tissues and causes itching and burning during intercourse.
You may be experiencing some pain from your disease, especially if you have myeloma. You could be worried that intercourse will be painful or cause bone damage.
Your emotional and mental state may also affect your sex life. Fear about your cancer or treatment, depression, anxiety, guilt, and tension in your relationship with your partner can all decrease your interest in sex. You may have extra worries on your plate such as finances, work and appointments, everything related to balancing your life with your cancer diagnosis. These things can distract you from intimacy and relationships.
If you are admitted to an inpatient hospital unit, lack of privacy for an extended period of time can also interfere with your sex life.
The Effect of Cancer Treatment on Your Sex Life
It is very common for chemotherapy to cause a change in your desire for sex, and couples usually report a decrease in sexual activity during chemotherapy. Chemotherapy side effects such as mouth sores, nausea, vomiting, or bowel problems like diarrhea or constipation may make it difficult for you to feel sexy. Chemotherapy can also cause menopause-like symptoms in women, impacting their sex drive and genital organs.
Radiation therapy can cause similar side effects as chemotherapy in terms of gastro-intestinal upset and fatigue. In addition, radiation to the pelvic area can cause changes to the vagina in women as well as problems with erection in men.
Stem cell transplantation and subsequent graft versus host reactions may also cause changes to the vaginal and penile tissues.
Weight gain or loss, hair loss, and skin toxicities are body changes that may make you feel less attractive or desirable. If you have a central venous catheter, or “central line,” you might wonder if it will get in your way during intercourse. Medications used to manage pain and side effects may also contribute to the problem.
Tips for Improving Your Sex Life during Cancer Treatment
- Communicate with your partner about your feelings and fears about sex
- Plan your sexual encounters for times after you have taken antinausea or pain medications so you will be comfortable. This may take away the spontaneity of sex, but will make it more gratifying in the long run
- Get creative! Experiment with different ways of touching and stimulation to achieve gratification. Remember that sex is not only about intercourse, it is also about intimacy. Holding each other, bathing together or cuddling may also bring pleasure to your partner. Videos, sex toys or masturbation (self stimulation) may also be an option.
- Get rested! A nap before intercourse may help with fatigue. Also consider sexual positions that are less physically demanding for you, such as having your partner on top, or side lying positions
- Relax and be patient. Pressure to perform for your partner or worrying about how they perceive you following your diagnosis will only make matters worse. Try to relax and work through these difficulties together. It may take time for you to be ready for intimacy and that is okay. Keep in mind that your treatment may go on for several months or even years.
Before You Begin
Be sure you use a method of birth control while you are undergoing treatment for your cancer. While therapy may decrease sperm count and ovulation (egg cell release), it can not be relied upon to prevent pregnancy. Methods of treatment can cause death and severe toxicity to a pregnancy, especially if a woman is under therapy.
If you have decreased immunity or bone marrow or suppression, penetrative intercourse such as penis to vagina, or penis to anus should be avoided. Ask your doctor when this type of activity is safe for you. Meanwhile, keep open-minded and experiment with different ways to stimulate your partner.
A condom or other barrier device should be worn during intercourse (including oral sex) for at least 3 days following chemotherapy treatments. Chemotherapy can be excreted in vaginal secretions and semen.
A cancer diagnosis can bring stress to even the most secure of relationships, and this can be magnified when difficulties with sex arise. Remember that your partner loves you for more than just your appearance or how you perform in the bedroom. Acknowledge that these difficulties are very common with people in your situation -- you are not alone, and neither is your partner. You have a lot going on right now! The key is to keep your communication and mind open while you find ways to incorporate sex into your new reality.
Shell, J. Impact of Cancer on Sexuality. In Otto, S. (2001)(ed)Oncology Nursing, 4th ed Mosby: St Louis. (pp.973- 1001).