Colorectal Cancer: Sex, Sexuality and Intimacy

You can have sex during treatment. 

• Check with your doctor or his/her nurse before having sex  to make sure there will not be complications.
• Sex during treatment is not recommended if:
  • Your immune system is low, including low count of white blood cells (“immunosuppressed”)
  • You have very low red  blood cell counts ("anemia")
  • You are in the first weeks of recovery after surgery
• It is not advisable to become pregnant during chemotherapy treatment. Pre-menopausal women should use safer sex techniques to prevent pregnancy and transmission of sexually transmitted diseases. To learn more, see:    Safer Sex: Level Of Risk Of Transmission of HIV and Other STDs .  

Side effects of chemotherapy which can affect sex and sexuality

Most effects from chemotherapy go away soon after treatment ends.

Possible side effects include:

• Hormonal changes such as menopausal symptoms, including hot flashes.
• Hair loss or thinning (For information about coping with hair loss, click here)
• Nausea and vomiting (For information about coping with nausea and vomiting loss, click here )
• Loss of appetite  (For information about coping with loss of appetite, click here )
• Hand and foot swelling and peeling of skin. For information, click here. 
• An emotional roller coaster, with the possibility of getting stuck in depression. . (For information about dealing with emotional issues, click here.
• Women:
  • Dryness of the vagina which can be painful even if there is no penetration.  
  • Narrowing (“stenosis”) of the vagina can cause pain on insertion of a penis or object.  
  • Early onset of menopause (“Medical menopause”) can include hot flashes, lower sex drive and an increase in vaginal dryness.
  • Mouth dryness and/or sores, thrush or candidiasis can result in the feeling that the last thing you want is anyone near your mouth. (To learn about preventing and dealing with mouth dryness, click here. For information about dealing with oral sores, click here.
  • Fatigue (due to low red blood cell counts) (To learn about dealing with fatigue, click here) 
  • Changes in sexual desire (“libido”).
  • Dry skin. (To learn about dealing with dry skin, click here
  • Fertility or ability to conceive. (For options to consider, click here. 
  • Low white cell count which can result in an increased risk of infection..
  • Bleeding or bruising after minor cuts or injuries because of a decrease in f blood platelets.
  • Poor body image (For information about identifying and dealing with poor body image, click here. 

NOTE: It is recommended that if you have sex during chemotherapy, use precautions such as a condom or dental dam so no fluids are shared. Chemotherapy chemicals can be found in semen or vaginal fluid. 

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