Sex and sex hormone symptoms
This page is about how hormone symptoms may affect your sex life. There is information about
Some cancer treatments lower the amount of sex hormones in the body. Or they may stop the body producing sex hormones altogether. The hormones most commonly affected are oestrogen and progesterone in women and testosterone in men. When this happens it can cause symptoms that may affect your sex life, such as a loss of sex drive, erectile problems for men, and vaginal dryness in women.
Some people are able to have hormone replacement therapy (HRT) to control any symptoms. But some treatments for breast or prostate cancer aim to either stop the body producing sex hormones or block their action. If you are having these treatments, unfortunately you can’t take HRT to help control your symptoms. But there are other things that may help.
Low levels of sex hormones can make you lose interest in sex. This is called loss of libido. The hormones testosterone, progesterone and oestrogen all play a part in sex drive. But not everyone who has low hormone levels has a loss of interest in sex. For most people, the cause is a combination of factors, rather than just the level of hormones in the body. These factors include
- Your age
- Your general health
- Stress and worry
- Loss of confidence and self esteem
- Other side effects of low hormone levels such as hot flushes
What you can do about this depends on what is causing the loss of libido. It is worth thinking about whether any of the factors listed above are relevant for you and if they could be adding to it. For example, are you tired? Treating or learning how to cope with tiredness could help to increase your libido. Once you know what is adding to your loss of libido, you can start to do something to try and improve it.
There is information about tiredness in our coping with cancer section. If you are not tired, could there be another cause? If there is, it is likely there is some help for it, so do tell your doctor or nurse and then they can help.
If you are in a relationship, talking to your partner about how you are feeling is important. Many people find it difficult to talk about sex even with a long term partner. But not talking about it can affect your relationship with them. If you don’t tell them, they may feel rejected or that you no longer love them. Even if you are not interested in having sex, you can still enjoy physical contact.
Hugging, cuddling and kissing are comforting and can help you to relax. If you have physical contact it is important to be clear with your partner about how far you are expecting to go. You may want to put intercourse on hold for a while. Some people find that feeling relaxed and having other physical contact can gradually lead to them becoming aroused and wanting to have sex. So a break may help in the long run.
Some anti depressants can cause a low sex drive. So, if you are taking a type of SSRI antidepressant such as Prozac, it may help to stop it. It is very important to speak to your doctor before you stop taking it though. You may have side effects if you stop suddenly. You will also need to talk to your doctor or nurse about whether the depression is likely to come back if you stop taking it.
Reduced amounts of testosterone in men can lead to problems getting and maintaining an erection. In an American study of nearly 400 men, 15 out of 100 (15%) said they had problems getting an erection. For most of these men, the problem started with hormone treatment.
Many men find this a very difficult side effect to cope with. It can often have a big effect on their confidence, self esteem and quality of life. If you have a partner, try to talk to them about it and let your doctor know. Researchers have found that many men don’t tell their doctor either because they are embarrassed or because they think nothing can help. But there are a number of treatments that can help, including
Drug treatments include sildenafil citrate (Viagra) and vardenafil (Levitra). These work by increasing blood flow to the penis. In American research this treatment worked in half the men taking the drug (50%).
Injections or pellets that you use each time you want to have sex are available. You can get them from your doctor or specialist nurse. You either have to give an injection into the penis before sex. Or you put a pellet into the opening of the urethra, at the end of your penis.
Vacuum pumps can help if you can’t get an erection or if the erection isn’t firm enough for penetration. You use the pump before sex. It works by drawing blood up into the penis. You then put a soft plastic ring around the base of your penis. This means you can keep the erection for as long as you want it.
Implants are semi rigid rods that a doctor puts into your penis during an operation. It means your penis is partly erect all the time. This method doesn’t suit everyone and is usually used when other methods haven’t worked.
Reduced amounts of sex hormones in women can cause vaginal dryness. This is very uncomfortable and makes intercourse painful. Oestrogen helps to maintain the firmness of the wall of the vagina. Without oestrogen the vagina and vulva may become thinner, more easily damaged, and less elastic. The tissues make less of the secretions that help keep the vagina healthy and make sexual intercourse comfortable.
If you have vaginal dryness you may also have itchiness and a discharge. We don’t know exactly how many women have this problem. But research suggests that at least half the women taking hormone treatment (50%) have a problem related to vaginal dryness.
If you have a hormone dependent cancer you won’t be able to take hormone replacement therapy to relieve your symptoms. Other non hormone treatments may help, including creams and moisturisers that you put into your vagina. You use some of these a few times a week, such as Replens. Others you use just before intercourse such as Vielle, Sylk, Yes, Durex lube, KY jelly, and Aquaglide.
If lubricants and moisturisers don’t help, ask your doctor or nurse about whether you could use vaginal oestrogen. Researchers have found that this can help but we need more research to find out how safe it is after breast cancer.
Two studies have found that vaginal oestrogen didn’t increase the risk of the cancer coming back. But we need larger trials to be certain about this. You can either use a cream or a pessary. A pessary is a small pellet that you put inside your vagina and gradually dissolves. Your body will absorb some oestrogen but the amounts are small. Research suggests that it doesn’t raise the levels of oestrogen in the blood.
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