Chemotherapy and sexual health

You may find that you lose interest in sex (also known as loss of libido) during chemotherapy. There are various reasons for this. You may be anxious about your diagnosis and treatment or be having side effects such as nausea and vomiting. You may simply feel too tired. Everybody reacts differently, but problems are usually temporary.

In some women chemotherapy drugs bring on an early menopause, which can also lead to a loss of interest in sex and other symptoms, such as vaginal dryness. You can read more about this in our Sexuality intimacy and breast cancer booklet.

Chemotherapy and fertility

Chemotherapy can affect egg (ovum) development, which in turn can affect fertility. If you're of childbearing age and considering having children, you’ll need to think carefully about fertility before you start chemotherapy. If you need referral to a fertility specialist this should happen quickly so that starting your chemotherapy is delayed as little as possible.

Some women find their periods become irregular or stop temporarily during chemotherapy. In others they stop completely, which may indicate permanent infertility. This depends on the type of drugs you're having, the dosage and your age. The risk of permanent infertility is greater if you are over the age of 35 and rises as you get older. You can find more information about this in our Breast cancer and fertility issues booklet.

Chemotherapy and contraception

You can carry on with your usual sex life during your treatment but it's advisable not to get pregnant because this may mean the chemotherapy has to stop.  Chemotherapy can affect the developing foetus, particularly in the first trimester (up to the first 12 weeks).

It’s important to carry on using contraception even if your periods become irregular or stop completely. To protect your partner, it’s a good idea to use a barrier contraceptive, such as condoms, in the first few days after each chemotherapy treatment (cycle), as chemotherapy drugs affect the whole body and may be present in body fluids. For the same reason you may want to avoid unprotected oral sex for the first few days, or any contact that involves the sharing of body fluids.

You might also think about using other methods of contraception once your treatment is complete. For example:

• diaphragm
• fitted IUD (coil) – but not one that works by releasing hormones.

The contraceptive pill may not be recommended because of the small possible risk of the hormones stimulating the breast cancer to grow. The morning-after pill can still be used for emergencies since a single dose of hormones is unlikely to affect your breast cancer.

Chemotherapy during pregnancy

Chemotherapy can be given during pregnancy. However, it should be avoided during the first trimester as it may lead to birth defects or miscarriage. Chemotherapy during the second and third trimesters is usually safe. Many pregnant women treated with chemotherapy at this time go on to have healthy babies, although there is a small risk of low birth weight and early delivery.

If you’re near the end of your pregnancy, it may be possible to induce the baby early so you can start your chemotherapy after the birth.

See our Breast cancer during pregnancy factsheet (additional link on the right hand side of this page) for more information.