Sex after chemotherapy: keeping a healthy sex life after prostate cancer

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Going through chemotherapy is a rollercoaster ride that can be tough both physically and emotionally. One concern that’s often not openly discussed, is chemo’s impact on your sex life. Chemo will affect your body in a number of ways, but it doesn’t mean the end of your sex life or intimacy. Read on for a rundown on how to keep your sex life healthy as you navigate the sexual health impacts of chemo.

Understanding chemotherapy and its effects on sexual health

Chemotherapy is a treatment where strong medicines are used to knock out cancer cells or keep them from growing. This hopefully ensures the cancer doesn't spread. However, it may lead to certain sexual side effects, such as:

You can find out more about what to expect from chemotherapy here.

Can you have sex while on chemo?

Let’s start with the big question: whether or not you can have sex while on chemo. Like a lot of medical questions, the answer is that it depends—so speak to your doctor or healthcare team to find out the specific advice for you.

But just because you’re going through chemo, doesn’t necessarily mean that your sex life has to suffer. You will, however, have to be aware of a few things and approach everything with open, honest communication.

Can chemo affect my partner?

Some types of chemotherapy can be found in your body fluids, including your saliva and semen. If a partner comes in contact with your body fluids, they could absorb some of the chemo, but we don’t know if this is actually harmful. To minimize any possible risk, use condoms and dental dams during sex, including oral sex. And if your partner can fall pregnant, it’s important to take precautions to avoid this.

If you are asking yourself ‘can chemo affect my partner?’—remember, as with anything to do with relationships, open and honest communication is key. Make sure to have a conversation about the side effects of chemo and the sexual needs of everyone involved.

Penetrative sex isn’t the only way to get or give pleasure. Don't forget to discuss other ways to maintain intimacy and explore other forms of sexual expression.

What about oral sex during chemotherapy?

Talk to your doctor about whether it’s safe to have oral sex during chemotherapy.

Doctors generally recommend using a condom or dental dam for oral sex during chemo and for one week afterwards. This is to prevent the possibility of the chemotherapy getting into your partner through your body fluids.

For the person undergoing chemo, there is a risk of infection (such as a yeast infection) due to the chemo making your immune system not work as well as it should. Condoms may help protect against infection while your immune system is weak from chemo.

Can you have unprotected sex after chemotherapy?

There are a few factors to think about when considering unprotected sex after chemotherapy:

  • How long it has been since the last chemotherapy session.

  • Ongoing side effects from the chemo and health concerns, such as infections or fertility issues.

  • Avoiding pregnancy (if this is a possibility for your partner).

To determine when it’s safe to have unprotected sex:

  • Talk with your healthcare provider for specific guidance.

  • Monitor yourself for potential side effects and complications.

How long does chemo stay in sperm?

Some doctors say it takes 48 to 72 hours for chemo drugs to leave your body after treatment, but exactly how long chemo stays in semen can depend on a number of things including the type of chemo and your physical health—it’s important to talk to your doctor about what to expect.

Unfortunately, chemotherapy can have a long-term impact on fertility by damaging sperm or reducing its production. Some sperm production might return, but can take many years, and sometimes does not return at all, leading to infertility. Chemo can also damage the quality of sperm—its ability to move and its genetic make-up.

If having a family is important to you, there are a number of steps you can take such as sperm banking or testicular sperm extraction. Your healthcare provider can provide more information and refer you to a fertility clinic.

What is the emotional impact of chemo on sex and intimacy?

Cancer treatment will bring up many emotions for you and your partner. It’s normal to feel worried, angry, and scared. You may feel a sense of grief and loss about the sexual changes from prostate cancer treatment. These feelings can test even the strongest relationships.

    To navigate these challenges, it may help to:

  • Talk openly and honestly about what’s happening with your partner.

  • Find ways to be intimate that don’t include sex (like cuddling or massage).

  • Remember to be gentle and patient with yourself and your partner.

  • Ask your doctor questions and educate yourself on what to expect.

  • Seek out support from a peer support group, family and friends, or a sexual health therapist.

Remember: Discussing the topic of sexual health during and after chemotherapy for prostate cancer can be a tough and emotional ride for both you and your partner. By getting familiar with the potential side effects and risks tied to chemotherapy, you can take the right steps to look out for yourself and your partner. It's all about keeping those lines of communication open, leaning on each other for emotional support, and staying in touch with your healthcare team.

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