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Sex and fertility

Chemotherapy may impact on your desire or ability to have sex because you feel tired or unwell. It may also affect sexual organs and functioning in both women and men. This can lead to a temporary or permanent effect on your ability to have children (your fertility).

Many people have a range of worries that cause them to lose interest in sex while they’re having treatment. They may feel less confident about who they are and what they can do, or there may be a physical reason for not being able or ready to have sex. For example, vaginal dryness or erection difficulties are common issues after treatment.

Partners may also feel concerned about having sex – they might fear injuring the person with cancer or feel uncomfortable with the changes in their partner. If you have sex after receiving chemotherapy, you should take safety precautions.

Sexual intercourse may not always be possible, but closeness and sharing can still be a part of your relationship. Talk about how you’re feeling with your partner, and take time to adapt to any changes.

Try to see yourself as a whole person (body, mind and personality) instead of focusing only on what has changed.

It is best for you and your partner to talk to your doctor about how chemotherapy might affect you personally and what options are available if you want to have children in the future. Women may be able to store eggs (ova) and men may be able to store sperm for use at a later date. This needs to be done before chemotherapy starts.

Some women’s periods become irregular during chemotherapy but return to normal after treatment. For other women, chemotherapy may cause periods to stop completely (menopause). After menopause, women can’t have children by natural means.

The signs of menopause include hot flushes, sweating—especially at night—and dry skin. Menopause, particularly if it’s early (before age 40), may cause bones to become weaker and break more easily. This is called osteoporosis. Talk to your doctor about medication to treat the symptoms of menopause.

Chemotherapy drugs may lower the number of sperm produced and reduce their ability to move. This can sometimes cause infertility, which may be temporary or permanent.

The ability to get and keep an erection may also be affected but this is usually temporary. If the problem is ongoing, seek medical advice. For more information, call Cancer Council Helpline for free resources on sexuality and intimacy.

Although chemotherapy reduces fertility, it is still possible for some women to become pregnant while having chemotherapy, and a man having chemotherapy could still make his partner pregnant.

Chemotherapy drugs can harm an unborn baby, so women should not become pregnant during the course of chemotherapy, and men should not father a child. Should you or your partner become pregnant, talk to your treating doctor immediately. The type of birth control you choose will depend on what you and your partner are comfortable using. Ask your doctor for advice about the best type of birth control method for you. Some people choose to use barrier contraception (e.g. condoms), which provide protection against any cytotoxic drug by-products that may be secreted in body fluids. Young women may be prescribed the Pill as a contraceptive and to help protect the ovaries from the effects of chemotherapy.