Cancer and its treatments can cause a number of problems related to the function of our sexual organs and sexuality. These concerns can  be broadly divided into three problem areas :-

Sexuality - Cancer or its treatments can affect sexuality in a number of ways:

• loss of libido - Any general illness, psychological upset, loss of self esteem or body image problems. Drugs such as Zoladex in men and women.
• vaginal dryness - Simply becoming post menopausal, radiotherapy to the vagina, drugs such as aromatase inhibitors (arimidex, aromasin & femara)
• vaginal pain - Infection, radiotherapy, surgery.
• erectile dysfunction - Age, hormones, surgery.

Fertility - issues after cancer?

• how is fertility affected
• fertility preservation

Menopause - brought on earlier by cancer treatments.

• causes
• coping strategies
• hot flushes

Safety -

• can sex cause cancer?
•  is sex safe after cancer?

.

Fertility can be impaired in both men and women can occur following chemotherapy, surgery or radiotherapy to the ovaries or testis for the following reasons, In women damage to the ovaries not only leads to infertility but early menopause in men removal of the testis will lead to reduced androgens and a type of menopause but surgery elsewhere in the pelvis and drugs will also lead to erectile dysfunction. The main causes of infertility include:

• Surgery (removal) of the testis or ovaries
• Radiotherapy to the testis or ovaries
• Chemotherapy
• Hormone therapy particularly LHRH modifiers (eg Zoladex)

In men it is possible to store sperm before chemotherapy. In women it is more difficult but recent developments in technology are now allowing measures  which could allow pregnancy after treatments has completed. Eggs can now be retrieved and stored although alternatives include storing fertilized eggs (ovum) but some centres are looking into storing sections of ovary. In the UK this service is not freely available on the NHS and only a few areas have the necessary licences to conduct such complex procedures (search fertility centres).

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.