Quick Overview

Chemotherapy saves lives—but it can also impact your body, hormones, energy, and emotions in ways that affect intimacy and sexual well-being. That’s not something you should have to just “deal with.” You deserve care for your whole self—including your sensual, emotional, and relational self.

This guide is here to help you understand what may happen and what you can do about it—on your own terms, and in your own time. 

Experiences you could have…

Physical Changes

• Vaginal dryness, tightness, or pain during sex
  
• Erectile dysfunction or delayed ejaculation
  
• Loss of sensation or increased sensitivity
  
• Hormone shifts (which may cause early menopause or reduced testosterone)
  
• Fatigue, nausea, or other body discomforts
  
• Changes in fertility (temporary or permanent)
  

Emotional & Identity Changes

• Feeling less “yourself” sexually or emotionally
  
• Difficulty feeling desirable, sexy, or interested
  
• Body image concerns (hair loss, weight changes – gains or losses, scars)
  
• Emotional distance or tension with a partner
  
• Grief, fear, or confusion around changes in desire
  

It’s Definitely Not Just You!

All of this is common—but rarely talked about. And it’s okay if you experience some changes. What matters most is knowing you’re not broken, and you have options for healing, exploring, and connecting in new ways.

What Can You Do to Minimize or Manage Any Effects You Experience?

Here are supportive strategies that many oncologists may not proactively mention, either because they’re not trained in this area or because it’s not part of standard care protocols. That’s why we are educating and informing you through this resource.

Education & Preparation

• Learn ahead of time which side effects are possible so they feel predictable rather than alarming.
  
• Ask your doctor or oncology nurse if the chemo drugs you’re being given are known to affect hormone levels or nerve function.
  

Medical Interventions

• Vaginal estrogen therapy (if safe for your cancer type) can help with dryness and thinning.
  
• Water-based or silicone lubricants and vaginal moisturizers (like Replens, Hyalo GYN, or, our favorite, Foria Everyday Vulva Moisturizer) can ease penetration discomfort.
  
• PDE5 inhibitors (like Viagra, Cialis) may help with erectile function.
  
• Pelvic floor physical therapy can support sexual function and comfort.
  
• Early hormone replacement therapy (if safe) for those experiencing early menopause.
  
• Medications for anxiety or depression if mental health is affecting desire or relational engagement.
  

Lifestyle & Support

• Gentle touch, sensuality, and non-penetrative intimacy can be emphasized as new primary expressions of sexuality.
  
• Fatigue management strategies, including timing intimacy for periods of higher energy.
• Explore pelvic floor physical therapy and/or sexological bodywork to restore comfort and sensation
  
• Use vibrators, dilators, or gentle massage tools to reconnect with pleasure
  
• Body image coaching or therapy, especially during hair loss or weight fluctuations.
  
• Solo exploration to rediscover pleasure pathways, even in a new body.
  

Communication and Relationship Care

• Share openly with your partner—or write them a letter if talking is hard. Dyads are also an excellent communication tool to use.
  
• Couples or sex therapy, especially if your partner is unsure how to navigate the changes.
  
• Practice mirror work or gentle self touch to rebuild body connection
  
• Seek a cancer and intimacy trained coach, counselor or therapist who understands sexuality and illness
  
• Give yourself grace. Healing gets to include your erotic and and emotional selves, too.

What to Ask Your Doctor or Care Team Members

We strongly encourage you to advocate for yourself by asking your doctor or other member(s) of your care team questions like the following:

• Will this treatment affect my sexual function or hormones?
  
• Are there any sexual health specialists you can refer me to?
  
• Can I safely use vaginal estrogen, ED meds, or other therapies?
  
• Can I talk to someone on the team about intimacy and relationships?
  

Final Word

You are allowed to feel tender. You’re also allowed to feel sexy. Whatever you feel is valid. There is no “right way” to move through this—only your way.

You don’t have to do this alone.

And your intimacy matters—before, during, and after treatment.