Sexual function 

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Cancer and its treatments can sometimes have a profound affect on libido and sexual function which in males is most often erectile dysfunction and women vaginal dryness or soreness. 

The most common causes of sexual dysfunction include:

In men:

• trauma to the pelvic region or spinal cord can damage veins and nerves needed for an erection

• surgery of the colon, prostate, bladder, or rectum may also damage these nerves

• radiotherapy to a lesser extent can also have an adverse affect but this depends on the dose and technique of administration

• drugs given for prostate cancer can reduce the male hormone (testosterone) levels, the most common culprit being LHRH modifiers ( eg Zoladex) but other drugs for depression and high blood pressure can also compromise sexual function

In women:

• radiotherapy to the lower pelvis can damage the glands which moisten the vagina and cause some thickening of the tissues

• drugs such as tamoxifen can cause uncomfortable vaginal discharge

• drugs for breast cancer such as those known as the aromatase inhibitors (arimidex, aromasin, femara) can cause vaginal dryness

For both males and females psychological wellbeing is very important for a healthy sexual function. Depression, lack out esteem, guilt and anxiety all contribute to loss of libido and erectile dysfunction. If a man experiences loss of erection, he may worry that it will happen again. This can produce anxiety associated with performance and may lead to chronic problems during sex. If the cycle is inescapable, it can result in impotence.

How can I help:

Medical intervention with lubricants and drugs such as viagra are certainly helpful and your specialist team should help with this issue. Various lifestyle interventions may also help particularly for erectile dysfunction (ED). The penis is very sensitive to changes in oxygen and blood supply, in fact ED is often the first sign in men of hardened arteries and reports have shown in men, in general, ED precedes angina by two years unless intervention is not taken. Lifestyle intervention is aimed at improving the blood supply to the pelvis and the oxygen in the blood stream. 

• Give up smoking – this alone will increase the oxygen in the blood stream by 20%. 

• Exercise regularly - regular exercise will generally improve the state of the blood vessels and increase the flow of oxygen to all tissues including the pelvis,

• Exercise will also help to loose weight which also helps ED (see how to exercise after cancer)

• Pelvic floor exercises are particularly useful as this directly stimulates the muscles around the penis but this need to be performed regularly (see pelvic floor exercises).

• Follow a healthy diet - diet of course will not only reduce weight, if that is an issue, but certain foods will have specific benefits on sexual function as well.

• Improve psychological well-being - psychological factors in impotence are often secondary to physical causes, and they magnify their significance. Improvement in your psychological well-being will certainly reflect in the sexual function and performance.

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.