Sexual Activity During Cancer Treatment: What You Need to Know

Sex during treatment is usually safe. But there are some health concerns to think about before sexual activity, which may include vaginal, oral, or anal sex. Talk to your care team if you have questions. They can help you take steps to keep you and your partner safe. 

Prevent pregnancy during cancer treatment 

If you have heterosexual vaginal sex, use a reliable method of birth control during cancer treatment, such as the pill, patch, or shot. Use condoms to prevent STIs.   

It is strongly recommended to wait until after treatment to have a baby. Being pregnant when you have chemotherapy or radiation has serious risks for an unborn baby. Chemotherapy and radiation could damage sperm, eggs, or an unborn baby. Your baby could have birth defects or other health problems. 

If a pregnancy occurs, doctors may stop therapy or change the treatment plan. This could affect your long-term health or chance of cure. 

Ask your care team how long you should wait before trying to get pregnant. 

Know the potential risks of sex during cancer treatment

During treatment, you may be at higher risk for:

• Bleeding and infection due to certain diseases and treatments 
• Exposing your partner to strong medicines that could be harmful to them 

Factors to consider before having sex during cancer treatment include: 

• Platelet counts: Make sure blood platelet counts are not too low. Platelets are blood cells that stick together (clot) to stop bleeding. When your platelet count is low, your body is less able to stop or control bleeding.
• Neutrophil counts: Make sure your absolute neutrophil count (ANC) is not too low. Neutrophils are a type of white blood cell that helps the body fight infection. A low ANC can raise your risk for problems like yeast infections or urinary tract infections. You can get your neutrophil count from a complete blood count (CBC) test.
• Chemotherapy: Wait 3 days (72 hours) after chemotherapy before having sex. This is the average amount of time that chemo takes to leave the body. Having sex with a partner within 72 hours of chemo treatment may expose them to these drugs.
• Radiation therapy: Sometimes treatment includes radiation that is placed inside your body or uses radioactive medicine. Examples include brachytherapy and MIBG therapy. Do not have sex until radiation is out of your body. Your care team will let you know when it is safe to have sex after this type of therapy.  

Practice safe sex during cancer treatment

It is important to use a condom or other form of barrier protection during sex, such as external (male) or internal (female) condoms or other barriers. This is especially important if your immune system is weak due to cancer or treatment.  

Sexually transmitted infections (STIs) are a risk for anyone who has unprotected sex. But the risk is higher if your body cannot fight off infections well. 

Benefits of using barrier protection include: 

• Lowering the risk of sexually transmitted infections 
• Protecting your partner from the harmful effects of radiation therapy or chemotherapy 

Talk with your care team about sex

It is important to talk to your care team about sexual health and any concerns you have. They can answer questions about: 

• Safe sex practices and how to prevent pregnancy 
• How treatment might affect fertility or your ability to have biological children in the future 
• Changes in sex drive, body image, relationships, or feelings of intimacy that may happen during treatment 
• Sexual problems or discomfort that may be a side effect of treatments  
• STI risk and prevention 
• How to get tested for STIs or pregnancy  

STI screening: If you are sexually active, get yearly STI screening tests for infections such as chlamydia, gonorrhea, and HIV. Your care team can let you know what tests are recommended for you based on your age, medical history, and risk factors. Let a care provider know about any new or unusual symptoms such as abnormal discharge, itching, burning, bumps, or rash in the genital area.  

Privacy and confidentiality: You may be uncomfortable talking to your care team about sexual issues. Or you may not want to share the information with your parents or other family caregivers. Your care team will protect your privacy as much as possible. They can also help you know how to talk to your partner. If you have concerns, let them know. 

Some states give health care providers the choice to inform parents that their child is seeking sexual health care services. Tell your provider if you want your conversation to stay private. 

Be honest about your feelings about sex

Everyone’s experience is different. Some people have no problems or changes in sexual desire or function. For others, challenges during treatment can make it hard to enjoy sexual intimacy. If you feel this way, you are not alone.  

Common barriers to sexual intimacy during treatment include: 

• Feeling tired or nauseous 
• Being self-conscious about body changes, such as hair loss, scarring, skin changes, or weight loss or gain 
• Vaginal discharge, bleeding, or discomfort due to vaginal dryness  
• Problems with getting or maintaining an erection 
• Pain from treatment or recent surgery 
• Lack of desire or interest in sex 
• Difficulty balancing a relationship with the stress and demands of cancer treatment 

Ways to cope with these issues include: 

• Wait to have sex until you feel physically and emotionally ready. Do not feel pressure to have sex.  
• Think about other ways to stay close. These can include kissing, cuddling, and massage. 
• Talk with your care team. They can help you understand what to consider before having sex.  
• If sex feels stressful or painful, a specialist may be able to help. Your care team can refer you to a psychologist, physical therapist, sex therapist, or other sexual health professional. 

Take care of your sexual health after cancer treatment

Let your health care providers know about your history. Create a survivorship care plan with your care team. Be sure to tell your health care provider about any sexual health side effects or concerns that you have.

Primary health care for females 

Every sexually active woman should regularly see a gynecologist. A gynecologist is a doctor who specializes in female health.  

Each person’s recovery after cancer is different. It might take time for your normal menstrual cycle (period) to return. If you have not had a period within 6 months after treatment, talk to your health care provider. Some patients need hormone therapy after cancer treatment. This therapy can support sexual health, as well as heart and bone health and overall well-being. 

If you have vaginal dryness, a water-based lubricant may help. Water-based lubricants prevent bacterial growth. Talk to your health care provider if symptoms persist. 

Primary health care for males 

Males should see a primary care provider for treatment of sexual problems or side effects. Side effects may include erectile dysfunction (ED), changes to the penis, changes in orgasm or ejaculation, and fatigue.  

Your sex life may be different during and after treatment. Be honest with your care team and your partner to address any concerns. 

Questions to ask your care team

• Is it safe for me to have sex during cancer treatment?
• What precautions do I need to take during sex?
• Will cancer affect my ability to have children later?
• How might treatment affect my sexual function and health?
• After getting chemo or radiation, how long should I wait to have sex?
• Are there any possible long-term changes in sexual health or fertility related to treatment?
• What resources are available for sexual health issues?

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