Find out about how anal cancer, and its treatment, can affect your sex life and relationships.
Sex after chemotherapy and radiotherapy
Skin soreness and general tiredness are common side effects of chemoradiotherapy. Radiotherapy can make the skin around the anus and genital area sore. So until your skin heals up, sexual intercourse may not be possible.
Radiotherapy and chemotherapy treatment for anal cancer can have long term side effects.
Women might have an early menopause, or dryness and narrowing of the vagina. Your doctor or nurse will suggest vaginal dilators to use after your treatment. Using dilators helps to stretch the vagina. Your doctor may also discuss using hormone replacement therapy for an early menopause.
Men might find they have difficulty in getting an erection after treatment.
Radiotherapy can cause scarring of the anus. This may affect the way your anus works. Some people may have problems controlling their bowels. In the long term, radiotherapy can change the lining of the bowel which can cause some bleeding from the anus. Treatments can help. Speak to your specialist if you are worried.
Having sex after surgery
You will need time to get over surgery before having sex again. Give yourself at least six weeks after major surgery.
An operation to remove the anus and the rectum can affect the nerves to the sex organs. A man may not be able to get, or keep, an erection. Women may find that their vagina shrinks and becomes a bit narrower. Using vaginal dilators after treatment may help prevent this happening.
You may have surgery to remove your anus and rectum as part of your treatment for anal cancer. If you're used to having anal sex, you will no longer be able to. Your surgeon and specialist nurse will talk to you about this before and after your surgery. There are other ways for you to enjoy a fulfilling sex life. Sharing your thoughts and feelings with your partner can help with this.
Having sex after a colostomy
If you have had a colostomy, you may also feel self conscious about the change in your body. You might worry about how the colostomy will affect your intimate relationships. Or you may be anxious about practical things like the stoma bag being noticeable or smelling during sex. A common worry for many people is that their partner will reject them.
Stoma bags these days are well designed. They are not visible under your clothes and shouldn't smell. If you do notice any smell, talk to your stoma nurse. It may be that the stoma bag doesn't fit well. The nurse can advise you on using a different type.
Intercourse won't harm your stoma. Make sure that your stoma bag is securely attached. Most positions you choose for having sex wouldn't affect your stoma bag. Find one that is most comfortable for you. You can also explore wearing underwear that covers the stoma. Pouch covers for the colostomy bag are also available.
Talking openly with your sexual partner can help your fears of rejection to disappear. Most of the time partners want to try to understand what you're going through and help if they can. This experience is also new to them. You may need time to feel confident enough to have sex again. Keep in mind that you can still be intimate with your partner through cuddling and kissing.
It often helps to talk things over with your partner and explain how you feel. It will take time for both of you to come to terms with all that has happened to you.
Your doctor and specialist nurse are also there to offer support. Your side effects may get better over time, but sometimes they can be permanent. If you feel worried, talk to your doctor or nurse. It’s normal to feel embarrassed when talking about sexual problems. Your doctor and nurse are sensitive to this and will understand.
Your doctor or nurse may be able to offer treatments that can help with your problems. They can also refer you to a specialist such as a counsellor or sex therapist for further support. You may decide that you want to talk to a specialist counsellor alone at first. You can invite your partner along in future.
If you're single, you might worry about how to tell a new partner about the changes to your body. It can be hard to talk about how certain problems might affect intercourse. A counsellor or sex therapist can help you find a way to do this.