How Hormone Therapy, Chemo, and Immunotherapy Can Affect Sex for Women
Hormone therapy, chemotherapy, and immunotherapy can cause sexual problems for many women with cancer. These problems can be temporary or last long-term after treatment has finished.
Learn how these cancer treatments can affect your sex life and how to get help managing problems that come up.
Talking with your cancer care team about sexual side effects
Don't assume your cancer care team will ask you about sexual problems. Remember, if they don't know you’re having a problem, they can't help you manage it.
- Before you start treatment, ask how it could affect sex for you in the future.
- As you go through treatment and follow-up care, tell them about any changes you have in your sexual life or any new problems that come up.
The information below describes common sexual problems faced by adult women (or people with female reproductive organs*) after certain types of cancer treatment. You might have problems or needs that aren’t addressed here. Your cancer care team can help you manage your specific situation.
*To learn more about the gender terms used here, and how to start the conversation with your cancer care team about gender identity and sexual orientation, see Gender Identity, Sexual Orientation, and Cancer Treatment.
How hormone therapy can affect sex
Hormone therapy may be used to treat certain cancers of the breast and the lining of the uterus (endometrial cancer). This treatment blocks hormones these cancers need to grow.
If you get hormone treatment, you may have many of the same symptoms that happen during menopause. These include:
- Hot flashes
- Menstrual cycle changes
- Vaginal dryness
- Pain during intercourse
- Lowered sex drive
There are different types of hormone therapy, and they don’t all cause these side effects. Ask your cancer care team what you can expect with your treatment and how you can manage these effects.
Let your partner know what might happen so you can work together to adjust.
To learn more about physical problems related to hormone therapy and how to talk to your cancer care team, see Managing Sexual Side Effects as a Woman with Cancer.
How chemotherapy can affect sex
Side effects from chemotherapy can affect your sexual desire and self-image in many ways.
Early menopause with chemo
If you haven’t gone through menopause, some types of chemo can interfere with your normal hormone function. This can lead to early menopause.
Early menopause can cause symptoms like:
- Irregular or no menstrual periods
- Hot flashes
- Vaginal dryness
- Thinning of the vaginal lining
These changes can make having sex uncomfortable. You might also notice a little spotting of blood after sex. Learn more about steps you can take to manage these changes in Managing Sexual Side Effects as a Woman with Cancer.
Effects of chemo on sexual desire
Chemo that is given into the blood stream (intravenous or IV) or by mouth can cause side effects throughout your body. Some of these side effects can impact your sexual desire.
Changes to how your body feels and looks can affect how attractive you feel and how much energy you have for sex. These side effects might include:
- Fatigue
- Pain
- Mouth sores
- Hair loss
- Weight gain or loss
- Nausea and vomiting
- Diarrhea
Anxiety or depression can also affect your sex life and leave little energy for sex.
Sexual desire often returns when you feel better in between cycles of treatment or after treatment is finished.
Effect of local chemo treatments on sexual desire
Some chemo is injected into your pelvis or bladder. This can cause pelvic irritation and make sex painful until your body heals.
- Chemo injected into your bladder: This treatment usually only has a minor effect on a woman’s sex life. But you might notice some pain during sex if your bladder and urethra become irritated.
- Chemo given by infusion into your pelvis and abdomen (belly): The medicines and extra fluid put into the space around the tumor cause your abdomen to swell. This treatment can also cause abdominal pain, which can make sex uncomfortable. The feeling should go away after the treatment course is finished.
Vaginal infections during chemo
Some chemo drugs can weaken your immune system, putting you at greater risk of infection. If you think you might have a vaginal infection, tell your cancer care team so you can get treated.
- Yeast infections: Yeast infections might happen during chemo, especially if you are taking steroids or antibiotics to treat infections from bacteria. If you have a yeast infection, you may notice itching inside your vagina or on your vulva. You may also have a thick, whitish discharge, and you may feel some burning during sex. Your doctor may prescribe a vaginal cream or suppository to reduce yeast or other organisms that grow in the vagina.
- Genital herpes or warts: If you've had flare-ups of genital herpes or genital warts in the past, chemo might make them happen again.
- STI: Take steps to avoid sexually transmitted infections (STI). Practice safe sex from start to finish (use condoms or other barriers to avoid body fluids). Do this every time you have oral, anal, or vaginal sex.
- Germs from your anus: Avoid touching your vagina and urethra with anything that has been used to stroke your anus. Germs from your bowels can cause infection if they get into these areas.
Sex and pregnancy during chemo treatment
Ask your cancer care team if it's safe to have sex while getting chemo. Many chemo medicines travel through your bloodstream to most of your body. Some types of chemo can directly affect how your sex organs function and the amount of female hormones your body makes.
Many chemo medicines used to treat cancer can also harm an unborn baby. Because of this, you will likely be advised to use effective birth control to keep from getting pregnant during treatment. Even if you think you can't get pregnant, talk to your cancer care team about this. It's important to know what kind of birth control is best and safest for you to use.
Ask your cancer care team how long you should wait after treatment before trying to get pregnant. There might be limitations to what you can do, or precautions you need to take to keep you and your partner safe.
Even if your period stops during treatment, it might still be possible for you to get pregnant. Women who don’t want to become pregnant should use birth control, even after having chemo, and should talk to their doctor about how long birth control will be needed.
If you think you might want to have children in the future, it’s important to talk to your cancer care team about this before starting chemo. You need to know if treatment will affect your fertility.
See How Cancer and Cancer Treatment Can Affect Fertility in Women for more information.
How immunotherapy can affect sex
Some types of immunotherapy for cancer can decrease the amount of female hormones your body makes. This can affect your interest in sex (libido).
This side effect often gets better with time and can usually be managed with medicines. Ask your cancer care team if the type of immunotherapy you are getting can decrease your female hormone levels.
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- References
Developed by the 91黑料不打烊 medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
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Last Revised: April 15, 2025
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