The Sexual Side Effects of Chemotherapy

Whenever the topic of chemotherapy side effects arises, we tend to think of hair loss, weight loss, and how sick the drugs could make us feel. What we don't often think about is sex.

Maybe that's because "cancer" and "sex" are two words that seem to cancel each other out when placed together. And, more often than not, sex is the last thing that comes to mind when faced with a cancer diagnosis.

But the simple fact is this: intimacy is important when going through cancer treatment. Sex and close intimate contact are known to promote feelings of well-being while moving you closer to your partner when treatment gets tough. This is why it's important to understand both the direct and indirect impact chemotherapy can have on your sex life whether you are 17 or 70.

Husband hugging wife with cancer
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Sex and Risk of Infection

People will often ask their healthcare provider when is the right time to have or resume sex with their partner. For most undergoing chemotherapy, sex is not only medically permissible, but it’s also encouraged.

In other cases, the opposite is true. People undergoing chemo are at often risk of developing neutropenia, a side effect of treatment that results in a low white blood cell count. These cells are vital for fighting off infection, and, without them, we are at risk for illnesses that might otherwise be harmless.

And that’s where sex can become a problem. Whether vaginal, anal, or oral, each of these activities has the potential to pass infection. While condoms can usually provide protection, it’s important to speak with your healthcare provider to make an informed choice based on your current health and any risk factors you may have.

If your immune system is severely compromised, sexual abstinence may be the only sure way to avoid infection.

Chemo and Pregnancy

It is important to always use birth control while undergoing chemotherapy, which may be mutagenic and induce birth defects. Both men and women should protect against pregnancy during chemotherapy.

Chemotherapy Side Effects

Chemotherapy can affect your sex life by either diminishing a person’s sexual function or giving rise to infections that can interfere with sex.

Some of the most common complaints:

  • Loss of libido can be expected from both men and women undergoing treatment. Chemotherapy often leaves you feeling sapped, with little time or desire for sex. These feelings are only increased when a person feels depressed or experiences things like hair loss or weight loss.
  • Erectile dysfunction (ED) is a condition in which a man is unable to achieve or sustain an erection. Some chemotherapy drugs are known to cause ED. Yet, even with drugs like Viagra and Cialis, many men still find it difficult to get an erection when faced with the stress and anxiety of cancer therapy
  • Vaginal dryness can also occur during chemo, causing pain and irritation due to the lack of natural vaginal lubrication. While water-based lubricants, such as KY Jelly, can definitely help, it’s always a good idea to speak with your healthcare provider to ensure that any over-the-counter product is safe and won’t cause irritation.
  • Vaginal infections are common in women undergoing chemotherapy, especially those taking antibiotics or steroids. The infections can cause pain, burning, and irritation to the vagina, often accompanied by a white vaginal discharge. Avoidance of sex is generally advised until the infection is fully cleared.
  • Genital warts or herpes flare-ups can also be a real problem. Because chemotherapy suppresses the immune system, viruses like human papillomavirus (HPV) and herpes simplex virus (HSV) are able to thrive where they might otherwise be controlled. In fact, some people who have never had an outbreak may suddenly be faced with one after starting treatment.

How to Cope

The good news is that most sexual side effects of chemo will go away after the completion of therapy. Symptoms can vary from person to person, with some being especially hard hit while others have minimal impact.

The main thing to remember is that the absence of sex does not mean the absence of intimacy. Even if you are unable to achieve an erection or endure intercourse, intimate touching and caressing can bolster both your outlook and feelings of self-esteem.

If experiencing any problems with sexual function, either emotional or physical, don't be shy about expressing them to your partner and healthcare provider. Communication is always key to remaining connected to both yourself and those who can help you.

12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Kelvin JF, Steed R, Jarrett J. Discussing safe sexual practices during cancer treatment. Clinical Journal of Oncology Nursing. 2014;18(4):449-453. doi: 10.1188/14.cjon.449-453

  2. Reese JB, Bober SL, Daly MB. Talking about women’s sexual health after cancer: Why is it so hard to move the needle? Cancer. 2017;123(24):4757-4763. doi: 10.1002/cncr.31084

  3. Ba Y, Shi Y, Jiang W, et al. Current management of chemotherapy-induced neutropenia in adults: key points and new challenges: committee of neoplastic supportive-care (Cons), china anti-cancer association committee of clinical chemotherapy, china anti-cancer association. Cancer Biol Med. 2020;17(4):896-909. doi: 10.20892/j.issn.2095-3941.2020.0069

  4. Memorial Sloan Kettering Cancer Center. Sex and your cancer treatment.

  5. Schover LR, van der Kaaij M, van Dorst E, Creutzberg C, Huyghe E, Kiserud CE. Sexual dysfunction and infertility as late effects of cancer treatment. EJC Suppl. 2014;12(1):41-53. doi: 10.1016%2Fj.ejcsup.2014.03.004

  6. Madan R, Dracham CB, Khosla D, Goyal S, Yadav AK. Erectile dysfunction and cancer: current perspective. Radiat Oncol J. 2020;38(4):217-225. doi: 10.3857/roj.2020.00332

  7. American Cancer Society. How Cancer Can Affect Erections.

  8. Lester J, Pahouja G, Andersen B, Lustberg M. Atrophic vaginitis in breast cancer survivors: a difficult survivorship issue. Journal of Personalized Medicine. 2015;5(2):50-66. doi: 10.3390/jpm5020050

  9. Chatsiproios D, Schmidts-Winkler IM, König L, Masur C, Abels C. Topical treatment of vaginal dryness with a non-hormonal cream in women undergoing breast cancer treatment - An open prospective multicenter study. PLOS ONE. 2019;14(1):e0210967. doi: 10.1371/journal.pone.0210967

  10. Teoh F, Pavelka N. How chemotherapy increases the risk of systemic candidiasis in cancer patients: current paradigm and future directions. Pathogens. 2016;5(1):6. doi: 10.3390%2Fpathogens5010006

  11. Aribi Al-Zoobaee FW, Yee Shen L, Veettil SK, Gopinath D, Maharajan MK, Kunnath Menon R. Antiviral agents for the prevention and treatment of herpes simplex virus type-1 infection in clinical oncology: a network meta-analysis. International Journal of Environmental Research and Public Health. 2020;17(23):8891. doi: 10.3390/ijerph17238891

  12. American Cancer Society. How Cancer and Cancer Treatment Can Affect Sexuality.

Additional Reading

By Lisa Fayed
Lisa Fayed is a freelance medical writer, cancer educator and patient advocate.