Sexual dysfunction is a real problem for female cancer survivors.
It is most commonly seen with breast or other gynecological cancers, but it can be a problem with any type of cancer.
Treatment often depends on the symptoms but can include therapy, counseling, and medication.
Sexual dysfunction complicates the lives of many women who have survived cancer. In fact, research suggests that up to half of cancer survivors experience symptoms of sexual dysfunction. And it can happen with any type of cancer. If you are a cancer survivor, you too may be struggling with sexual dysfunction.
Here, we’ll discuss how cancer can affect your sexual health and explore different ways to overcome sexual dysfunction as a cancer survivor.
Sexual dysfunction refers to any difficulty you may have with sex. Anything that decreases the pleasure you get from sex can be devastating. It can wreak havoc on intimacy in your relationship. Common symptoms include loss of sexual desire, pain with sex, or the inability to become aroused or have an orgasm. But sexual dysfunction may not look the same for everyone. It can include any or all of the following.
Loss of desire is also referred to as decreased libido. Two out of every three women treated for breast cancer report decreased libido. But it's a common problem with other types of cancers as well.
There are different reasons for why cancer treatment can lead to a decrease in your sex drive:
It may be because surgery leaves you feeling less attractive.
It may be because your cancer treatment affected your sex hormones.
It may be because you’re depressed.
It may even be due to the medications you now have to take to help treat your depression.
We know that any or all of these issues related to cancer can take away your desire for sex.
Pain with sex, or dyspareunia, is seen mostly after treatment for gynecologic and breast cancers. Almost half of breast cancer survivors complain of dyspareunia. But in reality, any cancer treatment that affects your sex organs can cause dyspareunia. Often, it’s seen after treatment that leads to a drop in sex hormone levels. Lack of hormones leads to vaginal dryness and often painful sex. But even with normal hormone levels, surgery in the areas around the vagina can cause painful intercourse.
You may have problems becoming sexually aroused or having an orgasm after being treated for cancer. Again, this is especially true if you’ve had treatment in areas like your breasts or vagina. These areas are directly involved in the process of sexual arousal, so any surgeries there can cause problems. Your sex hormone levels also play a role in sexual arousal and orgasm. Any treatment that lowers your hormone levels can also lead to arousal or orgasm issues.
Sexual dysfunction is usually related to how the cancer is treated. Treatments such as cancer surgery, chemotherapy, radiation therapy, and hormone therapy all have effects on your sexual health. But dysfunction can also be due to the emotional trauma of receiving a cancer diagnosis.
In most cases, surgery to cut out the cancer will be a part of the treatment plan. Surgery on some parts of the body, more than others, can have a negative effect on your sexual health. For example, having your ovaries surgically removed causes your hormone levels to fall, thus decreasing sexual desire. It also causes vaginal dryness that can lead to painful intercourse.
Surgery on your breasts or vagina will physically change these areas of your body. These are some of the most important areas to your body’s sexual function. Surgery in these areas will likely change the way you feel about yourself: It may make you feel less attractive and affect intimacy with your partner.
Reconstructive surgery can help with body image issues. But being able to become sexually aroused might still be a problem. This is because the surgically altered areas may no longer respond to touch like they used to.
Other gynecologic surgeries can also disrupt the anatomy in the area. Vaginal surgery will often shorten the vagina or you may heal poorly, causing scar tissue. Similarly, surgery for rectal cancer can also scar the area around the vagina, leading to painful intercourse.
Chemotherapy is a very potent medicine: It kills normal cells as well as cancer cells. This can cause damage to parts of your body not being treated for cancer. For example, if the ovaries are damaged by chemotherapy, they won’t produce hormones. As with surgical removal, this can lead to decreased libido, vaginal dryness, and painful intercourse.
Common chemotherapy side effects like nausea, vomiting, weight loss, and hair loss take a toll on your body. They can leave you feeling weak and tired. Such drastic changes to your body often leave you feeling less attractive and lacking in any desire for sex.
Like chemotherapy, radiation treatment, which involves burning the cancer out, often affects other parts of your body as well. Side effects of radiation depend on where in your body you receive treatment. They can include diarrhea, bladder irritation, scarring in your vagina, or damage to your ovaries. All these radiation side effects can lead to sexual dysfunction.
Cancers are sometimes treated with hormones as well. These hormones affect your body’s natural hormone production. They can lead to vaginal dryness, painful intercourse, and decreased sexual desire.
All types of cancer and their treatments have the potential to affect your sexual health. But more research has been done on breast and gynecologic cancers and their effects on sexual health. So we know more about how treatment for these cancers can lead to sexual dysfunction. We also know that these areas of your body play a big role in body image and sexual arousal.
It's not a surprise that cancer survivors often struggle with depression. If you are depressed, that alone can decrease your desire for sex. But many of the medicines used to treat depression can also affect your sex drive.
Other common problems you may face include anemia (low blood count), weight loss, muscle weakness, and fatigue. You may have issues with bowel and bladder control after cancer treatment. You may need to have a bag to drain your bladder or bowel. All these issues impact how attractive you feel and can all lead to a low sex drive.
First, it’s important to ask for help. You may feel uncomfortable or even embarrassed talking about these issues: This is normal. But your sexual health is a very important part of your overall well-being, so don’t be afraid to ask.
Your healthcare provider is a valuable resource when it comes to sexual dysfunction. They can guide you through treatment options to help with many of your symptoms, which include:
Lubricants and moisturizers to help with vaginal dryness or painful intercourse.
Physical therapy exercises to strengthen your weak muscles.
Referrals to counselors and support groups for support and guidance.
Prescription medicine and therapy for depression if you need it. If you’re already taking medication for depression, they can ensure it’s not one that will decrease your sex drive.
Unfortunately, none of these interventions will be 100% effective, 100% of the time. But there are many ways to significantly improve your sexual function and your overall quality of life after cancer.
Sexual dysfunction in cancer survivors is a common problem. All cancer treatments have the potential to affect your sexual health. The good news is, there are ways to overcome many of these problems to have a healthier post-cancer sex life.
ACOG Practice Bulletin No. 126 (2012). Management of gynecologic issues in women with breast cancer. The American College of Obstetricians and Gynecologists.
ACOG Practice Bulletin No. 213 (2019). Female sexual dysfunction. The American College of Obstetricians and Gynecologists.