Sex During Chemo: A Couple's Guide to Loss of Libido

Linsey Gold • February 25, 2022

Cancer diagnosis, chemotherapy, surgery, and other cancer treatments—all of these can impact physical, mental, and emotional health. But here’s one thing oncology healthcare professionals don’t talk about but should definitely include in cancer care plans: all of these changes can affect your sexuality and get in the way of your intimate relationships.

Because it’s rarely talked about, most cancer survivors are at a loss when maintaining a good sex life and sex health during chemotherapy.

Do you want to find out how to resume sexual activity during cancer treatment? Continue reading.

Should You Engage in Sexual Activity During Chemo?

Before we dive into the nitty-gritty of having sex during chemo, we have first to answer this question: is it safe to have sex during chemo?

To answer this, we need to consider a few essential risk factors. These are as follows:

Type of Cancer

Generally, it’s safe for cancer patients to have sex. However, you need time to heal before engaging in sexual activity if you have undergone treatment for certain cancers involving the urinary tract, genital area, rectum, anus, or breast.

For these types of cancer treatments, your doctor may recommend that you abstain from any sexual activities for a while.

Chances of Getting Pregnant

Getting pregnant during chemotherapy or after a cancer diagnosis is highly discouraged. This is because the harmful side effects of chemotherapy can affect you and your unborn child.

To minimize the chances of getting pregnant while your cancer treatment is ongoing, your doctor might recommend different birth control methods.

Pain

When you’re undergoing chemo, sexual intercourse can become quite painful, and there are many reasons why.

It may cause dyspareunia which is a recurring stabbing pain in the genital or pelvic area during intercourse.

Another reason would be vaginal dryness and tightening. The lack of lubrication will make sexual activity less enjoyable.

Your Sex Drive

The most common female sexual dysfunction associated with chemotherapy is low libido, and many things can cause it.

Some of the best examples are fluctuations in hormone levels, early menopause, poor body image, and low energy levels.

Risk of Infection

When undergoing chemo, you’re prone to having a low white blood cell count, which increases your risk of developing bacterial or yeast infections. Because of this, you’ll have minimal to no protection against the bacteria that gets introduced into your body during sexual activity.

Excessive Bleeding

In addition to increased risk of bacterial infection, chemotherapy can also decrease platelet blood counts, If your platelet levels are below 50000, there’s a chance of bleeding and bruising during sexual intercourse.

Your Partner’s Exposure

Chemotherapy medications may find their way into bodily fluids-- like saliva, vaginal fluids, and semen-- which your partner will be exposed to during sexual intercourse.

Studies show that people who are exposed to chemotherapy medication—but are not undergoing the said treatment-- may experience the following side effects:

- Sore throat

- Rashes

- Chronic cough

- Dizziness

- Hair loss

- Eye irritation

- Allergic reactions

- Miscarriage

- Infertility

While it’s still not clear whether these medications can be passed sexually, it’s better to err on the side of caution and carry out certain precautions when having sex during chemotherapy.

You and Your Partner Want to Have Sex, What Should You Do?

As per one 2014 medical review, sex is generally considered safe during cancer treatment as long as safety precautions are in place.

But with a lot of risks involved in having sex during chemo, you should only engage in any sexual activities if you have:

A platelet count of more than 50,000. Making sure you don't have low platelet count is important to minimize the risk of bleeding and bruising.

An absolute neutrophil count (ANC) of at least 500. Platelets play an essential role in preventing excessive bleeding. On the other hand, neutrophils are white blood cells that can help fight off different types of infections. Therefore, if you wish to minimize the risk of the urinary tract or yeast infection, you need to maintain the right ANC before resuming sexual activity.

Waited for 3 days after your last chemotherapy session before having sex. According to an article written by the American Cancer Society, chemotherapy drugs will stay in the body for around 24 to 48 hours before it’s excreted from your system. Avoid sex, including anal sex or oral sex, within the said period.

Talked to your healthcare team. You may feel quite uncomfortable talking with your healthcare provider about your sex life, but you must do so if you wish to understand how chemotherapy can affect your sexual health and what you can do about it.

When talking with your cancer care team, you must ask your healthcare provider about:

- the sexual health side effects that you may experience during the cancer treatment

- what you can do to manage the said side effects

- any cancer organizations or support group that can help you maneuver your new normal

Talked with your partner. Once you’re already aware of what sexual changes you can expect during the cancer treatment, the next step you need to take is to talk about it with your partner.

Let him know what changes he should expect, but more than that, be open with him about any feelings or inhibitions about your condition and how it can affect your sexual intimacy.

In this way, you can both develop ways to adapt to the physical changes and what precautions you need to take.

Make Sexual Activities Safer

You can have vaginal sex while undergoing chemotherapy, but keep in mind that it comes with a few risks. To minimize such risks, here are some of the precautions you need to take:

Ask your partner to wear barrier protection. Using barrier protection, like a condom, is highly recommended for you and your partner. For you, it can help reduce your chances of getting pregnant or the risk of infection. But, on the other hand, it can help protect your partner from exposure to the chemotherapy drugs in your bodily fluids and vaginal secretions.

Use contraception to avoid pregnancy. It's important to prevent pregnancy during chemotherapy because both you and your baby will be at risk. Chemotherapy may cause miscarriage or birth defects.

Additionally, pregnancy can also limit the types of tests and cancer treatment options you can have, making it more difficult for your doctors to develop a suitable cancer treatment plan for you.

When preventing pregnancy, don’t use the natural birth methods like pulling out or calendar method. Instead, go for more effective methods like a vaginal ring, birth control pill, patch, or condom,

Just make sure that you talk with your healthcare provider first to ensure that the contraception you will use won’t affect the effectiveness of your medications.

Preventing Pain During Sex

Painful sex is the number one reason most chemo patients are reluctant to have sex with their partners. Here are some ways how you can minimize pain during intercourse:

To address vaginal dryness, you can increase lubrication to make sex more comfortable and less painful. You can do this by using lubricants and vaginal moisturizers.

If you’re also dealing with vaginal atrophy, taking vaginal estrogens may also help. However, this is not recommended for people with Estrogen Receptor (ER) positive breast cancer.

Opt for sex positions where you have more control so you can control the speed and depth of thrusts to a level that’s less painful for you. If other areas of your body also feel sore, look for a position that will not put too much pressure on those areas.

Perform Kegel exercises regularly so you can control your pelvic floor and vaginal muscles and prevent them from becoming tense during intercourse.

Try seeking pelvic rehabilitation or pelvic physical therapy sessions so you can learn how to relax your vaginal muscles and manage your level of pain during intercourse.

Wear a vaginal dilator. This is a rubber or plastic tube inserted into the vagina to enlarge and stretch it so it won’t be too tight to minimize pain during penetration.

Making Sex Pleasurable Again

Aside from pain and dryness, other sexual problems you might encounter during chemotherapy are decreased sensitivity of your clitoris and the inability to reach orgasm fully. Here are some of the ways how you can resolve these issues:

Use sex toys, like a handheld vibrator, for extra stimulation.

Find the proper position for your legs. For example, many women reach orgasm faster when their legs are wide open, while others prefer pressing their legs together.

Explore with your partner to determine which type of touch arouses you the most.

Relax or tighten your muscles in the vaginal area in time with your breathing or in the rhythm of your thrusts so you can focus on what and how you’re feeling.

If Sex is Not on the Table, What Can You Do to Build Intimacy?

During a cancer treatment, it’s expected that you can’t be in the mood for sex all the time. But there’s one thing we would like you to know: there are other ways to promote sexual intimacy that doesn’t involve sex. Here are some of them:

Explore other activities that can build intimacy like kissing, cuddling, holding hands, massaging one another or even sharing sexual fantasies.

Try to reconnect with your partner by spending time with each other, listening to each other’s worries concerns, and validating each other’s feelings.

Spend your date nights exploring new things because the new experiences will make you closer to each other.

Finding Hope After Breast Cancer

Undergoing radiation therapy, chemotherapy, and breast cancer surgery will most likely affect your sex life and impact your sexuality. It can be traumatic and may even put a strain on your relationship.

What we want you to know is that there’s hope beyond breast cancer—not just for your health but your sexual function as well. A few studies show that sexual desire, satisfaction, and frequency usually return to normal a year or two after the diagnosis and treatment.

But as of now, you must understand that you can’t solve all your sex issues overnight. So there’s also no rush to do so.

Your body has gone through so many changes, and it can affect your emotional well being, mental, and sexual health. That’s understandable.

The best thing that you can do for now is to give yourself time. Don’t force yourself and stick to what you feel is right for your mind and body.

And when you already can, try to make a few small changes over time so you can reclaim your sexuality and you and your partner can bring back the sex life you once had.

< Older Post Newer Post >

Mail

Sex Life After Breast Cancer

By Linsey Gold • January 20, 2023

After cancer treatment, many women feel out of sync with their body. Here are tips to help you reconnect with your sexuality and empower you to make choices that are right for you.

8 Types Of Breast Cancer

By Linsey Gold • January 6, 2023

Breast cancer is the most common type of cancer in women, and it can occur in any part of the breast. There are many different breast cancer types, but all of them start with abnormal cells that grow out of control. These abnormal cells can invade and damage nearby breast tissue, including the lymph nodes under your arm, which is why it’s important to get regular mammograms and checkups. Early detection is key to successful treatment. In this article, we'll discuss the eight different breast cancer types. We hope this information will help you become more aware of the various types of breast cancer and their potential risks. RELATED: Breast Cancer And Exercise: The Role Of Physical Activity In Women With Breast Cancer 8 Breast Cancer Types Ductal or Lobular Carcinoma The most common type of breast cancer, ductal or lobular carcinoma, begins in the breast ducts or the lobules. This type of cancer can be invasive or non-invasive, and it's usually treated with a combination of surgery, radiation therapy, and chemotherapy. Ductal Carcinoma in Situ (DCIS) or Intraductal Carcinoma or Stage 0 Breast Cancer Ductal carcinoma in situ is a pre-invasive or non-invasive breast cancer. This means that there are abnormal cells in the lining of the milk duct, and they haven't spread outside of the duct. In most cases, DCIS is found through a mammogram before it can be seen or felt. While DCIS isn't life-threatening, it's still considered cancer and should be treated as such. Left untreated, DCIS may develop into an invasive breast cancer, which can be much more serious. This is why many doctors recommend treatment for DCIS even though it's a noninvasive cancer. Surgery is the most common treatment for DCIS. The type of surgery depends on the size of the tumor and how far it has spread within the ducts. Radiation therapy is often used after surgery to kill any remaining breast cancer cells. Invasive Breast Cancer or Infiltrating Breast Cancer Invasive breast cancer is a more serious type because it has spread outside the milk ducts or lobules into surrounding breast tissue. Once the invasive breast tumors spread to other parts of the body, such as the bones or lungs, they become metastatic breast cancer. While early-stage invasive breast cancer may not cause any symptoms, advanced stages of the disease can cause a variety of symptoms, including: a lump or thickening in the breast bloody discharge from the nipple changes in the size or shape of the breast skin dimpling pain Treatment options for invasive breast cancer typically involve surgery to remove the cancerous breast tissue, as well as radiation therapy and/or chemotherapy to kill any remaining cancer cells. In some cases, a combination of these treatments is necessary to achieve the best possible outcome. With early detection and proper treatment, most women with invasive breast cancer can go on to lead long, healthy lives. The two most common types of invasive breast cancer are: a. Invasive Ductal Carcinoma or Infiltrating Ductal Carcinoma (IDC) Invasive ductal carcinomas are the most common breast cancer type, accounting for about 80% of all diagnosed cases. It begins in the milk ducts, but quickly spreads beyond ducts and into the surrounding breast tissue. Although ductal carcinoma can occur in any part of the breast, it most commonly affects the upper outer quadrant. It can occur in any age group, but is more often diagnosed in post-menopausal women. Invasive ductal carcinoma is also the most common type of male breast cancer. b. Invasive Lobular Carcinoma (ILC) ILC is a type of invasive breast cancer that accounts for approximately 10-15% of all invasive breast cancers. Unlike other breast cancer types, which typically first form in the milk ducts, lobular carcinoma begins in the milk-producing glands (lobules) Invasive lobular breast cancer is often harder to detect on mammograms than other breast cancer types, so it's important for women to be aware of the signs and symptoms. While it can occur in women of any age, ILC is most commonly diagnosed in women over the age of 50. Apart from these two most common types, there are other rare breast cancers that are sub-types of invasive breast cancer. These breast cancers have cells with unique characteristics: Medullary carcinoma: This type is characterized by the presence of large cancer cells and is more likely to occur in women with a family history of breast cancer. Tubular carcinoma: Under a microscope, breast cancer cells from a tubular carcinoma look like tubes. This type makes up about 2% of all breast cancers. Mucinous (or colloid) carcinoma: This cancer looks very different from other types of breast cancer because it contains a large amount of mucin. Mucin is a jelly-like substance that's normally found in small amounts in mucous membranes, such as the lining of the gastrointestinal tract. Papillary carcinoma: This is characterized by long and thin tumors, similar in appearance to finger-like growths. It's usually found in older women. Adenoid cystic carcinoma: This is a type of cancer that typically affects the salivary glands. However, it can also occur in other tissues, such as the breast. It's characterized by the presence of two different types of cells--luminal and basaloid. Low-grade adenosquamous carcinoma: This is a rare variant of metaplastic breast cancer that's characterized by both glandular and squamous differentiation. Some subtypes of breast cancer have the same or even worse prognoses than invasive carcinoma, including: Mixed carcinoma: The prognosis of mixed carcinoma of the breast is quite good, with an average of eight-year disease-free survival. Metaplastic breast cancer: The five-year survival rate for this type is around 63%. Micropapillary carcinoma: This type is usually associated with a poorer prognosis than other types of breast cancer, but can be successfully treated in some cases. HER2-Positive Breast Cancer This is a type of breast cancer that's characterized by an overgrowth of the HER2 protein. This protein is found on the surface of healthy cells, and it helps to regulate cell growth. However, in HER2-positive breast cancer, the protein is produced in excess, causing the cells to grow and divide at an abnormally fast rate. Triple Negative Breast Cancer (TNBC) TNBC is an aggressive type of invasive breast cancer that's named "triple negative" because it's characterized by the lack of receptors commonly found in breast cancer: estrogen receptor progesterone receptor human epidermal growth factor receptor 2 (HER2) This means that the tumor cells aren't sensitive to hormone therapy, making it difficult to treat. They also tend to grow and spread more quickly than other types of breast cancer. Women with triple negative breast cancers are typically diagnosed at a younger age and have a higher risk of recurrence . RELATED: How To Improve Breast Health Inflammatory Breast Cancer (IBC) Inflammatory breast cancer is a rare form of locally advanced breast cancer, meaning that it has already progressed locally but has not yet spread through the lymph nodes or outside the breast. IBC accounts for only 1-5% of all breast cancer cases and typically occurs in younger women and in African American women. Symptoms can include: redness swelling warmth in the affected breast inverted nipple discharge from the nipple IBC is often mistaken for a breast infection, which can delay treatment and result in the cancer spreading. If you experience any of these symptoms, it's important to see a doctor as soon as possible. Less Common Types of Breast Cancers Some types of breast cancer are less common than others. This doesn't mean they're any less serious, but it does mean that they may not be as well-known. Here are three less common types of breast cancer: Paget's Disease of the Breast Paget disease is a rare form of cancer that affects the nipple and areola (the dark area of skin around the nipple). The disease gets its name from Sir James Paget, the doctor who first described it in 1874. Common symptoms include: a rash or crusting around the nipple itching burning pain Angiosarcoma Angiosarcoma is a type of cancer that develops in the lining of blood vessels or lymph vessels. It can occur anywhere in the body, but it most commonly develops in the skin, breast, or liver. Angiosarcoma is rare, and it's often diagnosed at an advanced stage. The prognosis for angiosarcoma is generally poor, but it varies depending on the location and stage of the cancer. With early diagnosis and treatment, some patients are able to achieve long-term remission. Phyllodes Tumor A phyllodes tumor is a rare type of breast tumor that arises from the breast's connective tissue, specifically the stroma. Its name comes from the Greek word "phyllodes," meaning "leaf-like." Phyllodes tumors tend to be large and bulky, and they can grow quickly. They're usually benign (non-cancerous), but in some cases, they can be malignant (cancerous). Phyllodes tumors are relatively rare, accounting for less than 1% of all breast tumors. Final Thoughts Breast cancer comes in many different forms and can affect people of any age, gender, or race. Understanding its different types is key to getting an accurate diagnosis and finding the best treatment plan. While breast cancer can be a serious illness, it's important to remember that it can also be successfully treated with early detection and advanced treatments. If you're ever concerned about a potential breast cancer symptom, don't hesitate to talk to your doctor. They can help you determine if it's something to be concerned about and make sure you get the care you need. Most importantly, remember to take your health into your own hands as much as possible—schedule regular check-ups with your doctor, maintain a healthy lifestyle, and stay up-to-date on breast health screenings. Doing this could save your life! Remember, early diagnosis is key for successful treatment of any type of breast cancer. Up Next: How To Take Care Of Your Breast Prostheses What Is A Mastectomy? | Everything You Need To Know The Best Bras After Breast Surgery