After treatment and remission

Sexual health

Leukaemia and its treatment can affect desire, comfort and intimacy. This topic explains, calmly and openly, why this happens and what helps.

Last updated: ~2 min read
Two glowing orbs of light close together.
Figure 1.Intimacy involves body and feelings.

01Short answer

Sexual health involves both the body and feelings. After treatment, many people notice lower desire, tiredness or worry about changes in how their body looks. The causes vary. Hormone changes: in women, early menopause and lower oestrogen can cause vaginal dryness and pain; in men, lower testosterone can weaken desire and erections (topic “Hormones”). After a transplant, chronic GVHD can affect the lining of the genitals (topic “Chronic GVHD”). Some medicines, tiredness, pain, anxiety and depression also play a part. Most of these problems can be treated: hormone replacement therapy, moisturisers and lubricants, medicines for erections, physiotherapy, and psychological and couples counselling. The most important step is to talk openly with your partner and your doctor.

02Simple explanation

Sexual health involves body and feelings.

Causes: hormones, GVHD, tiredness, mood.

In women: dryness, pain; in men: desire and erections.

Many problems can be treated.

Most important: talk openly.

03Scientific explanation

In women: according to the NCI, lower oestrogen after treatment can cause vaginal dryness, pain during sex and lower desire; moisturisers and hormone therapy can help.

In men: the NCI notes that lower testosterone, tiredness and some medicines affect desire and erections; medicines and other treatments are available.

After transplant: the COG and NCI note that chronic GVHD can affect the genital lining; regular gynaecology or urology reviews are recommended.

Feelings: the ACS highlights the effect of body image, anxiety and depression on sexual health; psychological and couples counselling help.

04What happens in the body?

Why does it change?

Treatment affects hormones, energy and the body; feelings and relationships can change too. This is a normal reaction.

The role of hormones

Oestrogen and testosterone affect desire and comfort. Low levels can be checked with a blood test.

A balance with droplets of light on each side.
Figure 2.Hormones affect sexual health.

In women

Vaginal dryness, pain and lower desire. What helps: moisturisers, lubricants, hormone therapy (with your doctor) and pelvic floor physiotherapy.

In men

Lower desire and difficulty with erections. What helps: checking testosterone levels, medicines for erections (with your doctor) and seeing a urologist.

Relationships and feelings

Talking openly with your partner, finding other forms of closeness, and seeing a psychologist or couples counsellor help.

A bridge of light joining two points.
Figure 3.Open conversation helps.

When to call your doctor

Worrying signs — fever, bleeding, new pain, breathlessness — should be reported to your doctor between visits too. Getting in touch early is always better than waiting.

05Supporting sexual health

Steps.

Notice — Notice changes calmly.1NoticeNotice changes calmly.
Talk — Talk openly with your partner.2TalkTalk openly with your partner.
Tell — Talk to your doctor in private.3TellTalk to your doctor in private.
Support — Treatment and counselling.4SupportTreatment and counselling.
IntimacyCloseness returns.
BalanceHormones are checked.
CommunicationOpen conversation.

06Possible changes (simplified)

ChangePossible causeWhat helps
Lower desireHormones, tiredness, moodDoctor, psychologist
Vaginal dryness, painLower oestrogen, GVHDMoisturisers, gynaecologist
Difficulty with erectionsTestosterone, medicinesUrologist, treatment
Anxiety, body imageThe experience of treatmentPsychological support

* Choose treatment together with your doctor.

07Key terms

Libido
Sexual desire.
Oestrogen
A female sex hormone.
Testosterone
A male sex hormone.
Erection
The penis becoming firm.
Lubricant
A product that reduces friction during sex.
Couples counselling
Psychological support for partners together.

08Key points

  • Changes are normal.
  • Many problems have solutions.
  • Talk openly with your doctor.
  • Talk with your partner.
  • Get your hormones checked.
  • Keep infection risk in mind.

09Frequently asked questions

It feels embarrassing to talk to my doctor about this.

Doctors are used to these questions; it is a normal part of health.

Is sex safe during treatment?

It depends on your blood counts; ask your doctor.

Do I need contraception?

Yes, during treatment and for a while after; discuss it with your doctor.

When will this pass?

It often improves with time and treatment.

Does this information replace medical advice?

No. This is general education; only your treating doctor can assess your situation.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. It feels embarrassing to talk to my doctor about this.

  2. Is sex safe during treatment?

  3. Do I need contraception?

  4. When will this pass?

  5. Does this information replace medical advice?

My questions

12Sources

  1. National Cancer Institute. Sexual Health Issues in Women with Cancer
  2. National Cancer Institute. Sexual Health Issues in Men with Cancer
  3. American Cancer Society. Fertility and Sexual Side Effects
  4. MedlinePlus (U.S. National Library of Medicine). Sexual Problems in Women
  5. MedlinePlus (U.S. National Library of Medicine). Sexual Problems in Men
  6. Children's Oncology Group. Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers
  7. National Cancer Institute (NCI). Follow-Up Medical Care
  8. National Cancer Institute (NCI). Cancer Survivorship
  9. Cancer.Net (ASCO). Follow-Up Care After Cancer Treatment
  10. Leukemia & Lymphoma Society (LLS). Long-Term and Late Effects of Treatment
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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