According to the American Cancer Society, a little more than one in three people will be diagnosed with cancer in their lifetime. Some of those cancers will require treatment, such as chemo or radiation, while others will require surgeries in addition to medication. Cancer isn't the only illness that's treated with chemotherapy — blood disorders and autoimmune diseases are also treated with it. And unfortunately, resources on how to talk about these difficult diseases don't always bring up how chemotherapy can affect your sex drive.
"I had a very high sex drive before chemo, and it vanished for the two years during and after treatment due to chemo, Tamoxifen's side effects, and my self-esteem afterwards (which is VERY common)," Melanie Childers, breast cancer survivor and life coach, tells Bustle. "After that drought, [my sex life is] pretty normal again, even though I'm 42 now and going through peri-menopause."
Chemotherapy is used to treat cancer and other illnesses by targeting growing cells that quickly divide and spread — which is the M.O. of cancer cells. While radiation treatment focuses on a specific part of the body, chemo can make its way throughout the body, also affecting that healthy cells that happen to be fast-growing (such as hair follicles). For this reason, chemo can also cause nausea, skin issues, or other side effects, which can in turn impact your sex drive.
As Childers explains it, she now has a very exciting sex life. She wants others to know that what they might be experiencing during chemo isn't necessarily going to be that way forever. "It's possible to bring it back to life," Childers says.
Though everyone's experience won't be exactly the same, experts say there are certain ways chemo may affect your sex life — and certain ways to help bring it back.
Higher Doses Of Chemo Do Negatively Affect Sex Drive
Chemo can take a toll on the body. It is exhausting, painful, and can result in physical changes.
“In my experience, neuropathy (numbness or change in sensation) ... and depression can be symptoms [and/or] side effects experienced while people undergo cancer treatment, all of which could impact sex,” Dr. Heather Overland tells Bustle. “More specifically, patients may experience diminished or changes in libido, fragile tissue, sores, erectile dysfunction, vaginal dryness, and pain with intercourse. Some of the side effects are limited during the course of treatment and some may last for years (or indefinitely).”
Further, other physical side effects can impact your interest in sex. “Obviously, fatigue, nausea, fever, pain, sores in one’s mouth, increased bruising, hair loss, constipation ... can force sex to take a back seat,” Dr. Kimberly Vandegeest-Wallace, PhD, a clinical psychologist with the University of Kansas Health System says.
Then There's "Chemo-Pause"
"If you're pre-menopausal when diagnosed with cancer, like I was at 34, chemo (depending on the type you receive) can completely wreck your hormones and sex drive," Childers says. "It can immediately put you into what some call 'chemo-pause,' which is essentially early menopause complete with hot flashes, lowered libido, and vaginal dryness in addition to the expected hair loss." She continues, "It's also at this time that your metabolism slows [and,] energy goes out the window ... because of the severe drop in hormones."
During this time, focusing on your physical comfort is most important, whether that's keeping your bedroom extra cool, or using extra lube when you're trying to have sex.
The Stress Of Being Sick Also Plays A Role
While there's no denying that some forms and doses of chemo can affect one's sex drive, a direct impact isn't always the case.
“For example, there is a portion of the population that experiences a dramatic decrease in libido when stressed," Vandegeest-Wallace says, adding that cancer and other illnesses can be "a stressor like no other.”
And Relationships Can Change During Illness
Getting sick is, as Dr. Vandegeest-Wallace put it, an immense stressor to the person who is sick. But for some people who are newly sick, their relationships might change as their loved ones negotiate becoming caregivers. Because our culture doesn't often talk about this transition, caregivers might treat their loved ones as a patient first, and a person second — an experience that can be super invalidating for the person who's sick.
“Navigating caregiving as a component of a relationship could be tricky, [just as] navigating dating while treating cancer could also feel complicated,” Dr. Overland says. “These issues are compounded by our illness-focused healthcare system. This system provides very clear details of types of cancer and appropriate surgical and chemotherapeutic options (which it should!), and unfortunately very few details about how a patient is going to get through the rest of their day, connect with their family, or be able to continue pursuing the things that give their lives meaning.”
Therapy, for the person going through chemotherapy and their partner, can help each person manage this life and relationship transition.
But None Of This Means Someone’s Sex Drive Is Gone Forever
However, undergoing chemo in no way suggests that someone shouldn't or can't have sex. According to Dr. Overland, it's important for the patient to have a person-centered approach, including discussions with their physician and partner, as to how to have and maintain a healthy sexual relationship, even if the sexual aspect is a little different than it was before.
"Going through [chemo] is a lot," Dr. Overland says. "[It's] also OK and perfectly valid for a person to decide that they don't want sex or a certain activity right then.”
She also points out that because chemo can do a number on vaginal health, seeking the advice of a doctor if you do want to have sex is paramount. It's important to ask them how to prevent pain during intercourse, what are the best lubes for vaginal dryness, and, ultimately, what you can expect in terms of other aspects of arousal. This is especially the case if the chemo triggers medical menopause, as Childers experienced in her mid-30s.
Dr. Vandegeest-Wallace also suggests a mindfulness-centered approach to getting in the mood. "For the next 30 seconds, close your eyes and imagine a moment in which you were sexually hungry, eager, excited,” she says. “Try to relive and re-experience a deep longing for your partner. Remember the smells, the emotions, the tastes."
More than anything, Dr. Vandegeest-Wallace says intentionality is really helpful in reclaiming your sexuality during and after chemo. It's just a matter of getting yourself there. It's this effort to reclaim that's something both partners need to recognize as a first step.
The physical side effects of chemo can of course affect sex drive, but “I think we need to respond to the deeper psychological impact,” Dr. Vandegeest-Wallace says. “Having cancer changes one's sense of self. Sexuality is about, literally, inviting someone to enter oneself. When we no longer know who we are, that is a difficult mountain to climb.”
But, as both doctors and Childers point out, this transition can be managed with open and honest communication with your doctor and your partner.
If you or someone you know is seeking help for mental health concerns, visit the National Alliance on Mental Health (NAMI) website, or call 1-800-950-NAMI(6264). For confidential treatment referrals, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website, or call the National Helpline at 1-800-662-HELP(4357). In an emergency, contact the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or call 911.
