Sex and Chemotherapy

If you’re receiving chemotherapy, targeted therapy, or immunotherapy, or have recently finished those treatments, it’s generally OK to have sex or be intimate with a partner if you feel physically and emotionally up for it. There are some things to keep in mind, though, to keep things safe for both of you.  

The guidelines — for protecting yourself from infection, using birth control, and even exposing your partner to your medication — are a little different when you’re getting chemo. 

These five tips can help make sex during treatment as safe and enjoyable as possible.

Before getting into any concerns about safety, you might be thinking about side effects. For many, sex during chemo seems less pleasurable or appealing due to treatment side effects like decreased libido, vaginal dryness, fatigue, mood changes, or body image issues. But support and treatment for these problems are available, and your oncologist or oncology nurse practitioner should be able to help. 

“I always encourage patients to discuss any sexual health concerns with their healthcare team so we can help address them,” says Erin Roesch, MD, associate staff breast medical oncologist at Cleveland Clinic in Cleveland, Ohio. Your healthcare team can potentially suggest treatments for sexual health side effects or refer you to specialists or to a sexual health clinic at a cancer center. 

Note that you may need to be proactive here — your care team may not bring up the topic unless you do. And of course, it’s important to keep the lines of communication open with your partner.

If it’s possible for you to become pregnant, doctors say it’s best to use birth control during treatment with chemotherapy, targeted therapy, or immunotherapy and for 12 months afterwards. These treatments could harm a developing fetus and could increase the risk of miscarriage. 

“We recommend that pre-menopausal women who’ve been diagnosed with breast cancer use non-hormonal forms of contraception, such as a non-hormonal IUD, diaphragm, or condoms,” says Dr. Roesch. Using hormonal birth control (such as the pill, patch, vaginal ring, implant, or hormonal IUDs) might increase the risk of the cancer coming back (recurrence).  

Men receiving chemotherapy or targeted therapy for breast cancer should also use birth control, such as condoms, because sperm can be damaged by those treatments.

Chemotherapy can weaken your immune system, leaving you more vulnerable to sexually transmitted infections and bleeding from intercourse. The degree of risk may depend on how immunocompromised you are at a given time. (One way your doctors measure this is by doing blood tests such as CBCs). If you are immunocompromised, ask your oncology team if you should avoid sex that involves penetration for a period of time or use barrier methods of birth control.  

If you’re receiving chemotherapy through a central line catheter, such as a port or PICC, take care during sex to avoid putting pressure on the area — especially if you recently had the catheter inserted or removed. You’ll also want to keep the dressing intact and prevent the tube from catching on anything.  

Some chemotherapy, targeted therapy, or immunotherapy medicines can potentially be passed to your partner through bodily fluids (vaginal secretions, semen, and saliva). To reduce that risk, consider using a condom for vaginal or anal sex and a dental dam for oral sex for the first seven or so days after each treatment.  

 

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