Sexual health after cancer treatment

It’s crucial to talk with patients about the sexual side effects of cancer treatment. Many patients understandably focus on surviving cancer first, so sexual health concerns often arise later in their treatment.

Cancer’s impact on the four domains of sex and sexuality

1. 1. Arousal: The physiological element of sexual arousal

   Challenges after cancer: Changes may occur in how a patient’s body experiences arousal. This includes difficulty with erections, thinning or dryness of the vulvovaginal tissues, and other physical side effects.

2. 2. Desire: The psychological interest in sexual activity, also called libido

   Challenges after cancer: Lowered interest in sex or loss of libido during or following cancer care is very common.

3. 3. Orgasmic and ejaculatory function: The ability to reach sexual climax

   Challenges after cancer: Patients can experience changes in their sensitivity, numbness in parts of the body, neuropathy that can disrupt their ability to reach sexual climax and trouble with ejaculatory function, especially in treatment for prostate cancer.

4. 4. Pain: Pain or discomfort with sex

   Challenges after cancer: Surgery in pelvic or genital areas or within reproductive organs can cause pain with sex, but pain also can be caused indirectly by physiological and hormonal changes brought on by chemotherapy or radiation.

"What the new sexual normal looks like during and after cancer care could be worlds different than what patients expected it to be. But that doesn’t always mean bad." Jennifer A. Vencill, Ph.D., L.P., Psychologist and sex therapist at Mayo Clinic’s campus in Rochester, Minnesota

The path to sexual recovery involves

• Patience

  We must have patience with a person's physical and mental health, as well as encourage people to have patience with themselves and their partners. A cancer diagnosis is often traumatic, and recovery takes time.

• Exploration

  Often, rediscovering optimal sexual health includes relearning the body’s sensations and erogenous zones, getting comfortable in a body that has drastically changed in look and function through cancer treatment, or exploring sexual aids.

• Support

  Both physical and mental therapies are available for patients, and it’s very important that they understand that these resources exist and how to use them. Educating patients and helping them build support systems is essential.

• Overcoming barriers

  Psychological and emotional stresses also are obstacles to sexual health. Seeking support from a professional to facilitate tough conversations can be extremely helpful.

Psychological and emotional barriers to recovery

The symptoms of stress, anxiety and depression are all very common for patients and their partners.

Open communication improves success

Partners’ abilities and comfort levels in discussing sex and sexual health, as well as their general attitudes around sex, can be predictive of how well they will do in this space.

The better able a partner is to talk openly with the patient about sex — which we often consider culturally sensitive — the better able the couple are to recover together sexually.

Communication supports recovery

Talking with your patients and encouraging them to talk with their partners is the first step toward recovering sexual health after cancer treatment. There are many resources — including sexual health specialists — that can help patients navigate the new normal as a cancer survivor.

Resources that can help include:

• Websites
• Books
• Support groups
• Sexual health specialists

Refer a patient

You can refer patients to Mayo Clinic securely online using the CareLink referral portal at CareLink.MayoClinic.org. To refer over the phone, contact your Mayo Clinic location.

For more information: O'Hara J. Mayo Clinic Q&A Podcast: Sexual Health After Cancer Treatment. Mayo Clinic. https://newsnetwork.MayoClinic.org/discussion/mayo-clinic-qa-podcast-sexual-health-after-cancer-treatment/.

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