SEXUALITY Sexuality is an intimate form of communication that involves not only intercourse but also touching, verbal expression and other demonstrations of affection. Neither cancer itself nor any therapy for the disease can destroy one's sexuality. Changes to body image may occur through the use of chemotherapy drugs, radiation, surgery or prosthesis. It may be temporary or permanent. It may also have positive, negative or no effect on your perception of sexuality. It is helpful to include your partner in your "journey" through this illness, including treatment and its possible effects. Communication with your partner and family, as a whole, is very important because adjustments sometimes involve or affect others beside you. An individual's self-image can be affected in a variety of ways - a loss of health, temporarily or permanently; side effects from treatment; feelings of isolation; etc. Fertility can be adversely affected by both chemotherapy and radiation therapy. This may be either permanent or temporary. Address this issue with your physician, the nurse, social worker or counselor. If you are concerned about the ability to have children in the future, ask about this prior to the initiation of any therapy/treatment. Information concerning agencies that deal with fertility (such as sperm banking) is available. Generally, pregnancy will not occur while on chemotherapy. It is still possible, however, so birth control should be used. The effects of chemotherapy medications are many and varied. Please discuss your concerns with your doctor or nurse. Note: Radiation therapy can have harmful effects on unborn children. Please advise your doctor or nurse if you have any reason to suspect you might be pregnant. Radiation therapy affects patients in different ways, depending on the site of the radiation field, the amount of radiation delivered, one's previous level of health, and beliefs about radiation. Side Effects That May Occur Include: Decreased blood flow to the genitals from vascular scarring (erectile dysfunction, decreased vaginal lubrication) Skin changes (skin becomes too tender for partner to touch; skin texture or color changes) Fatigue (possible loss of libido) Shortening vaginal vault (length of vagina) Vaginal stenosis (narrowing) Decreased vaginal sensation Alteration in sexual patterns Concern about bleeding Concern about possible recurrence of cancer Decreased skin sensitivity due to nerve damage Pelvic radiation may cause urethral irritation (women may experience pain with penetration or men with ejaculation) Radiation therapy may also impair fertility, depending on the dose to the testes or ovaries. Reproductive organs are shielded whenever possible to minimize potential damage. General Categories of Medications possibly affecting sexuality: Antihypertensives (High blood pressure medications) - erectile dysfunction, decreased vaginal lubrication, delayed ejaculation. Antidepressants - Decreased erections, decreased vaginal lubrication, decreased libido. Tranquilizers - May decrease anxiety and improve sexual functioning; delayed ejaculation; relax pelvis muscles and affect orgasm. Large doses may decrease erections and vaginal lubrication. Recreational Drugs - May cause euphoria and increase self-confidence; may increase tactile pleasure or block sexual arousal and pleasure; may cause extended, painful erection or painful ejaculations. Anticholinergics (Anti diarrhea medications) - Affects arousal (decreased erections and vaginal lubrication). Opioids (some pain medications) - Less pain increases enjoyment of sex. Side effects of constipation may interfere with sexual activity. Long-term opioids may retard ejaculation. Hormones - May decrease sperm, testosterone and thus, sexual desire. Secondary sex changes (deepening of voice, increased facial hair) may affect body image; hot flashes, painful intercourse due to decreased lubrication, mood swings. Endocrine Drugs - Hot flashes, painful intercourse due to decreased lubrication, mood swings. Added Note: Alcohol - Decreased libido; decreased vaginal lubrication and erections. Decreased inhibitions may interfere with use of safer sex and thus, increase risk of infections. Chemotherapy - Alopecia (hair loss), stomatitis (mouth sores), fatigue, anorexia, decreased immunity, amenorrhea (no menstrual periods), lowered ovarian function, absent of defective sperm, retrograde ejaculation. Return To Commonly Asked Questions