Cancer treatment: fertility and sexual side effects in women

Getting treatment for cancer can cause side effects. Some of these side effects can affect your sex life or fertility, which is your ability to have children. These side effects may last for a short time or be permanent. The type of side effect you have depends on your type of cancer and your treatment.

Cancers Most Likely to Have Sexual Side Effects

Many cancer treatments can cause sexual side effects. But you are more likely to have these side effects if you are being treated for one of these types of cancer:

• Cervical cancer

  Cervical cancer

  Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina.

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• Ovarian cancer

  Ovarian cancer

  Ovarian cancer is cancer that starts in the ovaries. The ovaries are the female reproductive organs that produce eggs.

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• Colorectal cancer

  Colorectal cancer

  Colorectal cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). It is also sometimes simply called colon ca...

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• Uterine cancer

  Uterine cancer

  Endometrial cancer is cancer that starts in the endometrium, the lining of the uterus (womb).

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• Vaginal cancer

  Vaginal cancer

  Vaginal cancer is cancer of the vagina, a female reproductive organ.

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• Breast cancer

  Breast cancer

  Breast cancer is cancer that starts in the tissues of the breast. There are two main types of breast cancer:Ductal carcinoma starts in the tubes (du...

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• Bladder cancer

  Bladder cancer

  Bladder cancer is a cancer that starts in the bladder. The bladder is the body part that holds and releases urine. It is in the center of the lower...

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Types of Sexual Side Effects

For women, the most common sexual side effects include:

• Loss of desire
• Pain during sex

Other side effects can include:

• Not being able to have an orgasm
• Numbness or pain in the genitals
• Problems with fertility

Many people also have emotional side effects after cancer treatment, such as feeling depressed or bad about your body. These side effects can also affect your sex life. You may not feel like having sex or may not want your partner to touch your body.

How Cancer Treatment Causes These Side Effects

Different types of cancer treatment can affect your sexuality and fertility in different ways.

Surgery for cancer:

• Pelvic surgery can cause pain and problems having sex or getting pregnant.
• Some women who have surgery to remove all or part of a breast find they have less interest in sex.
• The type of side effect you have depends on which part of the body where you have the surgery and how much tissue is removed.

Chemotherapy can cause:

• Loss of sexual desire
• Pain with sex and problems having an orgasm
• Vaginal dryness and shrinking and thinning of the vaginal walls due to lower estrogen.

  Vaginal dryness

  Vaginal dryness is present when the tissues of the vagina are not well-lubricated and healthy.

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• Problems with fertility

Radiation therapy can cause:

• Loss of sexual desire
• Changes in the lining of your vagina. This can cause pain and problems with fertility.

Hormone therapy for breast cancer can cause:

• Loss of sexual desire
• Vaginal pain or dryness
• Trouble having an orgasm

Talk About Side Effects

One of the most important things you can do is to talk with your health care provider about sexual side effects before your treatment. Ask what types of possible side effects to expect and how long they will last. This way, you will know what to expect. You should also talk about these changes with your partner.

If your treatment can cause fertility problems, you may want to see a fertility doctor before your treatment to discuss your options if you want to have children. These options may include freezing your eggs or ovarian tissue.

Sex During Treatment

Although many women continue to have sex during cancer treatment, you may find you are not interested in sex. Both of these responses are normal.

If you do want to have sex, make sure to ask your provider if it is OK. Also ask about using birth control. In most cases, it is not safe to get pregnant during cancer treatment.

Coping with Sexual Changes

Sex may feel different for you after your treatment, but there are ways to help cope.

• Focus on the positive. Feeling bad about your body can affect your sex life. Look for little ways to give yourself a lift, such as a new hairstyle, new makeup or a new outfit.
• Give yourself time. It can take months to heal after cancer treatment. Do not push yourself to have sex just because you think you should. Once you are ready, remember that it may take longer for you to feel aroused. You also may need to use a lubricant.
• Keep an open mind. There is not just one way to have sex. Try to stay open to all ways of being intimate. Experiment with new ways of touching. You may find that what feels good after treatment is not the same as what felt good before treatment.
• See your provider. If you are having pain with sex, tell your provider. You may be recommended creams, lubricants, or other treatments.
• Talk with your partner. This is very important. Try to be open about your feelings. Be honest about what would make you feel good. And try to listen to your partner's concerns or desires with an open mind.
• Share your feelings. It is normal to feel anger or grief after cancer treatment. Do not hold it in. Talk with close friends and family. It can also help to talk with a counselor if you cannot shake feelings of loss and grief.