Blood Cancer and Your Sex Life

The impact of leukemia, lymphoma, and myeloma on desire and physical intimacy

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Many patients are surprised at the effect that cancers like leukemia, lymphoma, or myeloma have on their sex life. Undergoing chemotherapy, radiation, or stem cell transplant for a blood cancer can affect libido and cause symptoms that affect physical intimacy. But the disease itself can also have effects that can impact sex, like fatigue and pain during intercourse.

There are a number of factors that can affect your desire for sex and your response to physical intimacy. Reviewing them, along with your partner, can help you better understand your situation—and what you can do to help it.

Though your priority is getting better, there's nothing wrong with being curious about how and why this part of your life might change because of your illness.

How Blood Cancer Impacts Sex

The effect that leukemia, lymphoma, or myeloma has on your bone marrow can create some limitations in sex. A low red blood cell count (anemia) may make you more tired than usual or make you easily short of breath. Cancer-related fatigue can further aggravate these symptoms.

You may also be worried about bleeding problems due to low platelets or concerned about infection when your white cell counts are low. For women, a weakened immune system can increase the risk of developing a vaginal yeast infection, which inflames tissues and causes itching and burning during intercourse.

You may be experiencing some pain from your disease, especially if you have myeloma. You could also be worried that intercourse will be painful or cause bone damage, making you more hesitant to engage in it.

Your emotional and mental state may also affect your sex life. Fear about your cancer or treatment, depression, anxiety, guilt, and related tension in your relationship with your partner can all decrease your interest in sex. You may have extra worries on your plate, such as finances, appointments, and everything related to balancing your life with a cancer diagnosis. These can distract you from intimacy and relationships.

And, of course, if you are admitted to an inpatient hospital unit, lack of privacy for an extended period of time can also interfere with your sex life.

The Effect of Cancer Treatment

It is very common for chemotherapy to cause a change in your desire for sex, and couples usually report a decrease in sexual activity during and after treatment. Chemotherapy side effects such as mouth sores, nausea, vomiting, or bowel problems like diarrhea or constipation may make it difficult for you to feel desirable. Chemotherapy can also cause menopause-like symptoms in women, impacting their sex drive and genital organs.

Radiation therapy can cause side effects similar to those of chemotherapy in terms of gastrointestinal upset and fatigue. In addition, radiation to the pelvic area can cause changes to the vagina in women, as well as problems with erection in men.

Stem cell transplantation and subsequent graft versus host reactions may also cause changes to the vaginal and penile tissues.

Weight gain or loss, hair loss, and skin toxicities are other changes that may impact how you feel about yourself. If you have a central venous catheter, or “central line,” you might wonder if it will get in your way during intercourse.

Medications used to manage pain and side effects may also contribute to the problem.

Improving Your Sex Life During Cancer Treatment

Thinking about your sex life may seem frivolous when you've been diagnosed with cancer. Still, your sexual health is an integral part of your overall wellness.

To improve things as you manage your blood cancer diagnosis:

  • Communicate with your partner about your feelings and fears about sex. Ask about his or hers as well.
  • Plan your sexual encounters for times after you have taken anti-nausea or pain medications so you will be as comfortable as possible. This may take away the spontaneity of sex but will make it more gratifying in the long run.
  • Experiment with different methods of touch and stimulation to achieve gratification. Remember that intimacy isn't just physical. Holding each other, bathing together, or cuddling may also bring pleasure to you both. Videos, sex toys, or self-stimulation may also be an option.
  • Get adequate rest; a nap before intercourse may help with fatigue. Also consider sexual positions that are less physically demanding for you, such as having your partner on top or positioning yourself on your side.
  • Relax and be patient. Pressure to perform for your partner or worrying about how they perceive you following your diagnosis will only make matters worse. Try to relax and work through these difficulties together. It may take time for you to be ready for intimacy, and that is OK. Keep in mind that your treatment may go on for several months or even years.

    Special Considerations

    Be sure you use a method of birth control while you are undergoing treatment for your cancer. Therapy may decrease sperm count and ovulation (egg cell release), but pregnancy is not impossible at this time. Some methods of cancer treatment can cause severe toxicity or death to a pregnancy.

    Genital herpes and warts can reoccur or flare up when your immune system is decreased. If you have decreased immunity or bone marrow suppression, penetrative intercourse should be avoided entirely. Ask your doctor when this type of activity is safe for you. Meanwhile, stay open-minded and experiment with different ways to stimulate yourself and your partner.

    A condom or other barrier device should be worn during intercourse (including oral sex) for at least three days following chemotherapy treatments. Chemotherapy can be excreted in vaginal secretions and semen, and a condom will help to protect your partner from unnecessary exposure.

    If you do not have a regular partner, it is also very important to take precautions so you don’t get any new sexually transmitted infections. Using condoms every time for all types of intercourse can help reduce this risk.

    A Word From Verywell

    A cancer diagnosis can bring stress to even the most secure of relationships, and this can be magnified when difficulties with sex arise. Remember that your partner loves you for more than just your appearance or your time in the bedroom. Acknowledge that these difficulties are very common in people in your situation. You are not alone, and neither is your partner. The key is to keep your communication and mind open while you find ways to incorporate sex into your new reality.

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    Article Sources

    • Shell, J. Impact of Cancer on Sexuality. In Otto, S. (2001)(ed) Oncology Nursing, 4th ed Mosby: St Louis. (pp.973- 1001).