Sexual and Fertility Problems (Women)
Many cancer treatments and some types of cancer can cause sexual and fertility-related side effects. Whether or not you have these problems depends on the type of treatment(s) you receive, your age at time of treatment, and the length of time since treatment.
It is important to get information about how the treatment recommended for you may affect your fertility before you start treatment. Many women also find it helpful to talk with their doctor or nurse about sexual problems they may have during treatment. Learning about these issues will help you make decisions that are best for you.
Treatments That May Cause Sexual and Fertility Problems
- Some types of chemotherapy may cause symptoms of early menopause (hot flashes, vaginal dryness, irregular or no periods, and feeling irritable) or lead to vaginal infections. It may also cause temporary or permanent infertility.
- Hormone therapy can stop or slow the growth of certain cancers, such as breast cancer. However, lower hormone levels can cause problems (hot flashes, vaginal discharge or pain, and trouble reaching orgasm). These problems are more likely in women over the age of 45.
- Radiation therapy to the pelvic area (vagina, uterus, or ovaries) can cause:
- symptoms of menopause (hot flashes, vaginal dryness, and no periods)
- pain or discomfort during sex
- increased risk of birth defects; use a method of birth control to avoid pregnancy
- vaginal stenosis (less elastic, narrow, shorter vagina)
- vaginal itching, burning, or dryness
- vaginal atrophy (weak vaginal muscles and thin vaginal wall)
- Surgery for cancers of the uterus, bladder, vulvar, endometrium, cervix, or ovaries may cause sexual and infertility-related side effects, depending on the size and location of the tumor.
- Other side effects of cancer and its treatment, such as fatigue and anxiety, can also lower your interest in sexual activity.
What to Expect
Before starting treatment talk with your health care team to learn what to expect, based on the type of treatment you will be receiving. Get answers to questions about:
- Infertility. Ask if treatment could lower your fertility or make you infertile. If you would like to have children after treatment, talk with your doctor or nurse before you start treatment. Learn ahead of time about options such as embryo banking, ovarian tissue banking, ovarian transposition, and clinical trials for egg banking. Talk with your doctor or a fertility specialist to learn more about these procedures and others that may be available through a clinical trial.
- Pregnancy. It is important to prevent pregnancy during treatment and for some time after treatment. Ask your doctor or nurse about different methods of birth control, to choose one that may be best for you and your partner.
- Sexual activity. Ask your doctor or nurse if it is okay for you to be sexually active during your treatment period. Most women can ne sexually active, but you will want to confirm this with your health care team.
Talking With Your Health Care Team
Prepare for your visit by making a list of questions. Consider adding these questions to your list:
Sexual and Sexuality-Related Questions
- What problems or changes might I have during treatment?
- How long might these problems last? Will any be permanent?
- Is there treatment for these problems?
- Would you give me the name of a specialist that I could meet with?
- Is there a support group for women that you would recommend?
- Will my fertility be affected by the treatment I receive?
- What are all of my options now if I would like to have children in the future?
- Could you give me the name of a fertility specialist who I can talk with to learn more?
- After treatment, how long should I use birth control?
Listen to tips on how to manage changes in sexuality and fertility caused by cancer treatments such as radiation therapy.
(Type: MP3 | Time: 3:55 | Size: 3.7MB)
Radiation Therapy Audio Transcript
What Women Can Do About Changes in Sexuality and Fertility
What women can do about changes in sexuality and fertility caused by radiation therapy.
You may be wondering if radiation therapy could affect your sex life. Let's listen to a discussion between Dr. Williams and women in a support group as they talk first about sexuality issues that relate to all women getting radiation therapy. And then to questions from women receiving radiation therapy to the pelvic area - such as to the vagina, uterus, or ovaries - about fertility issues. Let's listen in on their discussion.
Dr. Williams, I'm Gina. My husband and I had a pretty active sex life before I started treatment. Now, I'm just not in the mood. Is this normal?
Yes it is, Gina. You're going through a lot these days. Coping with cancer, feeling very tired, or being in pain can lower sexual desires. Try to be easy on yourself. It can help to talk with your husband about what you're feeling. There are many ways to stay close during this time other than having sex. Holding, hugging, and cuddling are ways that help many people stay connected.
That's true, Dr. Williams. My partner and I sit side by side when we watch TV. And sometimes we give each other backrubs. My question is about whether or not I need to use birth control during radiation therapy.
Yes, women who've not yet gone through menopause and who are having intercourse should talk with their doctor about birth control and ways to keep from getting pregnant.
It's very important not to get pregnant during radiation therapy. The treatment can harm an unborn baby.
Dr. Williams, I am getting radiation to my pelvis, and it's causing some changes in my vagina. It feels dry and itchy, and, frankly, sex hurts.
I'm sorry to hear that. This is a common side effect for women getting radiation to the pelvis. Many women are helped by products such as Replens, Astroglide, or K-Y liquid. These products help make the vagina moist. Your doctor may also suggest a gel or cream to stop an itchy, dry, or burning feeling.
In some cases, something called a dilator can also help. It stretches the vagina. Talk with your nurse to learn more about this product.
Dr. Williams, before I got cancer my husband and I were ready to start a family. Now I'm not so sure if that's going to be possible. What can we do?
Cara, I'm glad you asked about that. First, it's good to know that there are more fertility options these days than there used to be. It's best to talk with your doctor before treatment starts if you'll be receiving radiation therapy to the pelvis and would like to get pregnant after radiation therapy.
Your doctor can talk with you about things you can do now to plan for the future or refer you to a fertility specialist.
Any more questions?
Well, okay—it's been a pleasure to talk with all of you. I'll be staying around to answer any individual questions that you may have.
Remember—you may have less desire for sex during radiation therapy. Talk with your partner to find new ways to show affection and feel connected.
If you are having sex, make sure to use birth control since radiation therapy can harm an unborn baby.
And for women getting radiation to the pelvis there are 2 suggestions:
First, ask your nurse about products that can help make the vagina feel more comfortable or stretch the vagina.
Second, talk with your doctor before treatment if you are interested in having children after treatment. There are things you can do now to plan for the future.
Finally, be sure to talk with your health care team to learn more about how to manage and prepare for any changes in sexuality and fertility that may happen.