How Does Chemotherapy Affect Your Sexual Health?
Chemotherapy is the chemical treatment of cancer using drugs. The primary purpose of chemo is to kill cancer cells, shrink tumors, relieve symptoms of untreatable cancer and prevent it from returning.
It can be administered in several different ways but is usually given through a needle or tube inserted into a vein or orally—by mouth in capsule, liquid or tablet form—over a period of time. This treatment can be used in conjunction with other therapies, such as radiation therapy, immunotherapy and surgery. Progress is monitored by an oncologist, a cancer specialist who will perform various tests to see how the cancer responds to chemotherapy.
While chemotherapy has come a long way, it still has side effects that can influence all areas of your life.
How does chemotherapy affect general health?
Aside from the symptoms and problems caused by the cancer itself, chemotherapy can have myriad side effects.
"One of the most common side effects of chemotherapy is myelosuppression, or lowering the blood counts," said Mohamad Cherry, M.D., the medical director of hematology at Atlantic Medical Group Hematology Oncology in Morristown, New Jersey.
He noted that this treatment can impact the body in the following ways:
- Lowering platelets can cause bleeding.
- Lowering the red blood cells can cause anemia and lead to fatigue.
- Lowering the white blood cells can affect the immune system and increase the risk of infections.
Different chemotherapeutic agents create different side effects. These can vary depending on the type and stage of cancer, he added.
Some of the other common side effects of chemotherapy include the following:
- Appetite loss
- Bleeding
- Bruising
- Constipation
- Hair loss
- Mouth soreness
- Nausea
- Vomiting
Cherry recommended talking with your doctor about the best way to treat the symptoms of chemotherapy, as there are medications and other tools to help manage these side effects. Methods like cooling caps can help prevent hair loss, and antiemetic medication can reduce vomiting and nausea.
It is important to look after your mental health, he added, as this is an aspect of cancer treatment that is often ignored. Some cancer sufferers find that speaking to a therapist is helpful.
How does chemotherapy affect sexual health?
"Chemotherapy can, unfortunately, impact sexual health in many ways, although not everyone has these symptoms," said Anne Peled, M.D., a breast cancer surgeon and the co-director of the Breast Care Center of Excellence at Sutter Health California Pacific Medical Center in San Francisco.
She explained that women can experience the following sexual side effects as a result of chemo:
- Decreased interest in sex
- Early menopause
- Hot flashes
- Menopausal symptoms
- Vaginal dryness
- Vaginal pain
Men can experience:
- Decreased sex drive
- Lower testosterone levels
"Chemotherapy can also impact future fertility, which is unfortunately not always discussed before treatment when options like sperm and egg harvest are potentially available," Peled added.
If you would like to have children, this is something you can discuss with your doctor before chemotherapy starts.
Whitney McSparran, L.P.C.C., a counselor who specializes in relationships, stress, grief, anxiety and self-esteem at Thriveworks in Cleveland, Ohio, explained that there are other forms of intimacy partners can share that don't involve intercourse.
"Exploring non-sexual forms of physical intimacy like massage, cuddling and hand-holding can be helpful in maintaining a sense of intimacy when sexual activity isn't on the table," she said.
Complications and related conditions
The powerful nature of chemotherapy means it can cause serious complications.
"Certain chemotherapeutic agents can affect the heart, causing congestive heart failure or arrhythmias, and others can affect the lungs, causing shortness of breath," Cherry said.
Chemotherapy drugs can especially affect the kidneys and liver, he added, which can result in increased liver enzymes or a decrease in kidney function. These organs will be closely monitored throughout treatment.
If any severe complications arise as a result of chemotherapy, your doctor will adjust your schedule or prescribe supportive medication to help your body to better cope or recover.
Living with chemotherapy
While undergoing chemotherapy, it's important to build a support network of friends and family to go along with a healthcare team. Cherry recommends asking for social worker support as well.
It is important to be open and honest about your cancer and treatment, even when you feel uncomfortable talking, in order to maintain those relationships, McSparran said.
"Many healthcare systems may have social workers or nurse navigators that can answer questions or help facilitate these difficult discussions," she said.
Many people find that they can live relatively normal lives while on chemotherapy and even continue their day-to-day responsibilities.
Dating and relationships with chemotherapy
"Transparency, boundary setting and communication are important in all dating relationships but are especially important when navigating dating and chemotherapy," McSparran said.
Her advice for managing romantic relationships while undergoing chemo includes:
- Accept that your priorities or values may change.
- Be aware that your relationship may change as a result of cancer and cancer treatment.
- Be clear on your expectations of the relationship.
- Be clear about the time and energy you have to commit.
- Be open to talking about what is and isn't working.
- Explore possible solutions to your feelings and problems.
Practicing safe sex is very important during chemo, as these drugs can severely harm a pregnancy in the first trimester.
It may help partners to join a support group where they can speak to others whose relationships have been impacted by cancer.
Supporting someone and aftercare
"Don't rely on the person going through chemo to tell you what they want or need. Know the type of support you can provide and be consistent," McSparran said.
She stressed the importance of looking after yourself, as being someone's support during cancer treatment can take its toll.
McSparran recommended these strategies as the most important so that you look after yourself while you're caring for someone on chemo:
- Find a professional to talk with if you need to.
- Lean on your own support network.
- Practice self-care.
Chemotherapy and cancer can have unexpected impacts, so it is vital to keep checking in with yourself as well as the person you're caring for.
Whatever you're going through, there is likely someone else who has been through a similar experience. Charities, groups and online resources can provide emotional, financial and practical help during your time of need.
Resources for patients and caregivers
Here are some great resources to start learning more about chemotherapy and its potential effects:
