Find out about sex and fertility issues after acute myeloid leukaemia (AML) treatment.
Your sex life and AML
There is no physical reason why having AML or its treatment should affect your sex life. But you will probably go through times when you don’t feel like having sex because you are too tired, or you have other side effects of treatment.
Contraception during treatment
It is important to use reliable contraception during treatment. Getting pregnant while you (or your partner) is having treatment is not a good idea, because the leukaemia drugs might harm the baby.
Even if you are using other forms of contraception, you should also use barrier contraception. We don't think any of the drugs would get into your bodily fluids, but there is a small chance that they could. So you need to use barrier contraception to protect your partner.
Fertility after AML treatment
If you haven’t had children you might be worried about your fertility. Unfortunately, most of the treatments for AML are likely to make you infertile. So you won't be able to become pregnant or father a child afterwards.
Permanent infertility is almost certain if you have intensive treatment, such as a bone marrow transplant or stem cell transplant. Your doctor will tell you if it is likely you will become infertile. If you have a partner, you might want to see your doctor together so you can both discuss any fears or worries. Don’t be afraid to ask questions. Being well informed can help you cope.
Women and infertility
Chemotherapy can affect a woman’s fertility by stopping the ovaries from producing eggs. If this happens, you won’t be able to become pregnant and may have symptoms of the menopause. If you have an early menopause, your doctor might offer you hormone replacement therapy (HRT) to reduce menopausal symptoms.
HRT replaces the hormones you would normally produce – oestrogen and progesterone. Having HRT doesn’t mean you will produce eggs but you may still have a period each month. HRT can also help to prevent longer term problems like thinning of the bones (osteoporosis) and heart disease.
You take HRT as a tablet or you can have a skin patch, like a plaster (bandaid). The dose of hormones is lower than you would normally produce if you had not had an early menopause. So you are very unlikely to have any side effects.
Radiotherapy can also affect your fertility, this includes total body irradiation. Even small doses of radiotherapy to the ovaries can stop them producing eggs. Radiotherapy can also affect the womb so that it is unable to support a baby.
Men and infertility
Chemotherapy can affect a man’s fertility by:
- reducing the number of sperm you make
- affecting the ability of the sperm to fertilise an egg
This may be temporary or may mean you can no longer father a child.
Radiotherapy can also affect fertility so that you can no longer produce sperm.
Unfortunately, treatment for AML often has to start very quickly, so it is not usually possible to bank sperm beforehand.
Doctors are researching new treatments that aim to reduce the risk of infertility, but still cure the leukaemia. Men under the age of 25 have a better chance of producing sperm compared to men over the age of 40.
A study in 2006 looked at the effect of a stem cell transplant on men’s sperm. It found that a small number of the men started producing sperm again, especially if they were under 25 years of age. This is promising but we need more research, as it is not certain that this meant that they would be able to father a child.
Coping with infertility
It can be extremely distressing to find out that your leukaemia treatment will stop you being able to have children. It can seem very unfair to have to cope with this as well as your leukaemia. Even if you hadn’t thought about having children before, losing your fertility can be very difficult to cope with. It can also affect how you feel about yourself.
It takes time to adjust. You need to give yourself time to come to terms with it.
Talking to other people
Talking to your friends and relatives about your cancer can help and support you. But some people are scared of the emotions this could bring up and won’t want to talk. They might worry that you won't be able to cope with your situation.
It can strain relationships if your family or friends don't want to talk. But talking can help increase trust and support between you.
Help your family and friends by letting them know you would like to talk about what’s happening and how you feel.
You might find it easier to talk to someone outside your own friends and family.