How Cancer Affects Sexual Functioning and Sexual Health

Sex and sexuality are important parts of everyday life and include how you feel about yourself, your relationships and your sexual functioning.  

Cancer take a toll on your body in many ways. Some of the most common sexual problems that occur with treatment are listed below.

If you’d like help with any of these conditions, talk with your physician about a referral to City of Hope’s Clinical Social Work or Occupational Therapy programs.

Body Image and Self-Esteem

  • Cancer treatment can change how you look, affecting your self-image. It’s important to focus on what you love about yourself and activities that make you feel confident.  
  • Eating right, exercising and practicing relaxation techniques, such as mindfulness or meditation, can help keep your body strong and your spirits up.  
  • City of Hope’s Positive Image Center provides a supportive environment for those who have undergone appearance-related side effects of cancer treatment. The center’s licensed cosmetologists offer advice and personal consultations to meet your needs, including cosmetic and skin-care techniques, and alternatives for complete or partial hair loss.

Sexual Desire (Libido)

  • Sexual desire can decrease for many reasons, including the fear of having cancer, worries about treatment and the effects of the treatment itself.  
  • Talk to your partner about your feelings and concerns. Keep in mind you can enjoy other forms of closeness, such as touching, caressing and holding each other.  
  • If you are experiencing anxiety about sex and would like to speak with someone, ask your doctor for a referral to a social worker.


  • Try to have clear, two-way talks about sex with your partner and with your cancer care team.
  • Share your feelings honestly; good communication is key to adjusting to your sexual routine when cancer changes your body.
  • Talk about the good and the bad with a focus on solutions, how you’d like things to be, your feelings and actions you can take.
  • Couples Cope with Cancer Together is a support group available for patients and their partners to learn new coping strategies, identify and communicate needs, plan for different scenarios and understand stress triggers. Contact the Biller Resource Center for more information.


  • Pain can affect feeling pleasure during sex, decrease your desire to have sex, or make it difficult or impossible to achieve intercourse positions that you enjoyed in the past.  
  • Pain in the genitals or other parts of the body can affect your participation in a fulfilling sex life.  
  • There are many techniques to reduce pain during sex, including using lubrication or positioning your body differently.  
  • City of Hope’s Occupational Therapy program can find the right interventions for you. If you’re experiencing pain, ask your doctor for a referral.

Erectile Dysfunction

  • Many men who undergo surgical cancer treatments will have some difficulty with erections (called erectile dysfunction or ED).  
  • Some men will be able to have erections firm enough for penetration, but not as firm as before. Others may be unable to get erections.  
  • The good news is that there are several different treatments for ED. It may take some time, but if you’re willing to try different options, you’ll likely find one that works for you. Ask your provider about available treatments.


  • Cancer-related fatigue is one of the most common and distressing side effects of cancer and its treatment.
  • Manage fatigue by planning your day with short, 30-minute rest breaks, getting involved in aerobic or strength-building exercise programs (with physician approval), and prioritizing the activities most important to you.

Precautions for Sex During Treatment

As a general rule, follow your cancer care team’s advice on sex during treatment.
  • Sex and Chemotherapy: During chemotherapy, your immune system may be weak, so it’s important to practice safe sex by using condoms or other barriers to avoid bodily fluids. It’s especially important to avoid contact with the anus, as germs from the bowel can cause infections.
  • Sex and Radiation Therapy: In general, radiation therapy from a machine outside the body doesn’t leave any radiation in the body, so your partner won’t be affected. If you have a radioactive implant, sex might not be allowed until the implant is removed.
  • Sex and Hormone Therapy: Women undergoing hormone therapy may experience menopausal symptoms, including hot flashes, menstrual cycle changes and vaginal dryness. Men undergoing hormone therapy may experience a decrease in desire for sex (libido). In spite of these changes, women and men should still be able to feel sexual desire and reach orgasm.