Sexuality and reproduction
Introduction
Your sexuality and reproductive functions could be affected by cancer diagnosis and its therapy. Some of these changes are temporary while others may be permanent. We understand that this is not always an easy topic to discuss with your health care team, but it is very important that you do so. You have to realize that you are not alone and that many patients experience some changes in sexuality and reproductive ability. Your physician and nurse have experience in addressing these issues and may have strategies available that can help. Some of the common problems are discussed below.
Decreased Libido
Libido refers to person’s sexual drive. Loss of libido can occur to both men and women and is usually related to the physical and emotional effects of cancer and chemotherapy. Common causes include changes in body image brought on by hair lose, changes in weight or side effects of treatment; fear, guilt and anxiety; painful sexual relations.
Communication is your most important tool in coping with libido issues. Make sure that you talk about your feelings with your significant other.
It is also very important for both women and men to continue to feel good about yourself and your appearance. Looking better may actually make you feeling better. Visit the LOOK GOOD sites in the Internet links section (In-text tab only) for information and help.
Menopause
During chemotherapy you may experience irregular menstrual cycles or actual cessation of menstrual cycles (amenorrhea). Menopause during chemotherapy may be delayed or immediate, as well as permanent or temporary. In addition to changes in your regular menstrual cycles you may experience menopausal symptoms such as hot flashes, emotional changes, vaginal dryness and weight gain. Many pre-menopausal women recover ovarian function and their periods return after treatment is completed. If a woman is close to menopause prior to starting therapy, it is more likely that she will experience menopause symptoms during chemotherapy and the more likely that menopause will be permanent.
Strategies below could help you cope with some symptoms of menopause :
Vaginal pain or dryness can be treated with hormone replacement therapy (only for cancers not affected by hormone treatments), vaginal moisturizers or lubricants, vaginal dilators or anesthetic gels.
Hot flashes can potentially be treated with hormone replacement therapy (only for cancers not affected by hormone treatments) and antidepressants, deep breathing and other relaxation techniques. Cooler room temperature could help also help. Please do not take any medications without consulting with your physician first.
Emotional changes can include irritability, difficulty concentrating, anxiety, headaches, depression, insomnia, mood changes and energy loss. Management of these types of changes may be difficult as there may be many other factors involved. You will need to talk with your physician about the best intervention for you.
Impotence
Impotence or erectile dysfunction can be caused by the effects of treatment (chemotherapy, radiation, hormonal therapy or surgery) or by cancer itself, in particular, cancers of the prostate, reproductive system, bladder, colon and rectum. Other disease processes such as diabetes, high blood pressure, circulation problems as well as older age, medications (such as antidepressants, heart medications), heavy smoking and alcohol use can also cause impotence.
If you are experiencing impotence talk with your physician or nurse. There are treatment options available to help you copy with this problem.
Sterility
Sterility in cancer patients occurs secondary to specific cancers and to the medications used to treat those cancers. Other factors such as surgical procedures or radiation therapy on any part of the reproductive system can contribute to sterility in both men and women. You may not be thinking about becoming a parent but it is important to consider whether or not you may want children. Procedures such as sperm and egg banking are available but must be completed prior to starting therapy. Sterility may be temporary or permanent.
The primary cause of infertility in men is related to a lower number of sperm cells and a reduction in the ability of the sperm to move. Sperm banking for men is a relatively safe, simple and effective way to maintain your option to father a child in the future no matter what happens to your own fertility. Only a few live sperm cells need to survive the freezing and thawing process in order to create a pregnancy. Sperm banking for men is fairly cost efficient. Most banks require a minimum of 3 semen samples. There is a $150 charge per sample and a $50 a year charge per sample storage fee. Most sperm banks require that these costs be paid up front for 5 years. If sperm banking is an option you want to consider please talk with your physician or nurse prior to starting therapy.
Cancer treatment in women can affect the ovaries and reduce the amount of hormones they produce. For women facing the possibility of cancer-related infertility, many options are available, but none as practical or successful as sperm banking. Embryo freezing and egg freezing are expensive, time consuming and complicated. These procedures can require postponing treatment for up to four weeks, which may not be a reasonable option. Infertility can be temporary or permanent. Whether or not it occurs and how long it lasts depends on many things, including the type of drug, dosage given and your age. If you are considering becoming a parent please talk with your physician or nurse prior to starting therapy to determine the best option for you.
Chemotherapy and pregnancy
Birth Control during Chemotherapy: Pregnancy during chemotherapy is possible but is strongly advised against because some anticancer drugs may cause birth defects. Birth control is necessary during treatment and for several months after treatment. You will need to talk with your physician or nurse to determine the safest method of birth control for you to use.
Internet links:
American Cancer Society has multiple resources for cancer patients who experience problems with sexual and reproductive issues. Some of the links are presented below:
Sexuality for women and their partners
http://www.cancer.org/docroot/MIT/SexualityforWomenandTheirPartners.asp
Sexuality for men and their partners
http://www.cancer.org/docroot/MIT/SexualityforMenandTheirPartners.asp
Chemotherapy and Sexuality
http://www.cancer.org/docroot/MIT/content/Side_Effects_of_Chemotherapy_on_Reproduction_and_Sexuality_women.asp
Radiation Therapy and Sexuality
http://www.cancer.org/docroot/MIT/RadiationTherapyandSideEffectsonSexuality.asp
Look Good... Links
Look good, feel better
http://www.lookgoodfeelbetter.org/index.htm
American Cancer Society
http://www.cancer.org/docroot/ESN/content/Look_Good_Feel_Better.asp