Quick Overview

Hormone therapy (sometimes called endocrine therapy or hormonal blockade) is often used to treat hormone-sensitive cancers like breast, prostate, ovarian, or endometrial cancer. These treatments drastically alter the levels of estrogen, testosterone, or other hormones in the body—disrupting not only sexual function but often identity, desire, and emotional stability.

This treatment can be long-term and deeply impactful—yet patients are rarely prepared for how much it can affect intimacy and sensuality.

Common Sexual Side Effects of Hormone Therapy

These vary depending on which hormone is being suppressed, your baseline hormone levels, age, and whether other treatments (like chemo or surgery) were also involved.

Physical effects:

• Loss of libido (often sudden and complete)
• Vaginal dryness and atrophy (thinning of vaginal tissue)
• Pain or tearing during penetration
• Loss of erections or difficulty maintaining arousal
• Erectile dysfunction or inability to orgasm
• Genital shrinkage or tissue sensitivity
• Hot flashes, night sweats, and disrupted sleep
• Weight gain, fatigue, and loss of muscle tone
• Loss of natural lubrication or genital blood flow
• Breast tenderness or shrinkage (for some patients)
  

Emotional & psychological effects:

• Mood swings, irritability, or depression
• Loss of connection to one’s erotic self
• Feeling “flat,” “asexual,” or emotionally shut down
• Grief around gender identity, desirability, or loss of a sensual self
• Shame or fear around being a “burden” in a relationship
• Reluctance to discuss changes with a partner or care provider
  

What You Can Do to Minimize or Manage These Effects

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.

Education & Preparation

• Ask ahead of time: What will this medication do to my hormones and what side effects from that might I expect?
• Clarify whether the changes are temporary or long-term. Some people will be on hormone therapy for 5–10 years.
• Acknowledge that sexual and emotional changes may take you by surprise—but you’re not alone or broken.
• Remember: hormone changes don’t erase your right to desire or intimacy. You may need to relearn your body in the process though.
  

Medical Interventions

• Use lubricants and vaginal moisturizers to reduce dryness and pain.
• Ask about low-dose vaginal estrogen (if your doctor says it’s safe) to ease atrophy and improve tissue health.
• Consider topical testosterone or compounded therapies if levels are extremely low (must be evaluated for safety).
• PDE5 inhibitors (like Viagra or Cialis) may help erectile function even in the absence of desire.
  
• Pelvic floor therapy can support blood flow, pain relief, and comfort during sex.
• Medication or therapy for depression or mood shifts related to hormonal changes.
  

Lifestyle & Support

• Practice non-demand sensual touch with yourself and with your partner to rebuild body connection without pressure.
• Use arousal-enhancing tools (audio, massage, fantasy, erotic stories) to coax the erotic system awake.
• Explore new pathways to pleasure—what worked before might not be what works now. However, the pathways to pleasure are truly limitless.
• Talk to a therapist or coach familiar with cancer and intimacy; hormone therapy can be emotionally disorienting.
• Try movement practices like yoga or dance to awaken sensation and reconnect with physicality.
• Give yourself permission to grieve the changes—and also permission to rediscover what’s possible.
  

Questions to Ask Your Oncologist

• What changes should I expect in my body, emotions, and libido?
• Will these changes go away when the therapy stops?
• Is there anything I can do to minimize vaginal atrophy or erectile dysfunction?
• Can I safely use any topical hormone therapies?
• Can I be referred to a pelvic therapist, sex therapist, or counselor?