Sex, fertility and acute lymphoblastic leukaemia (ALL)

Having acute lymphoblastic leukaemia (ALL) and its treatment might affect your sex life and fertility Open a glossary item. Find out more.

Your sex life and ALL

There's no physical reason why having ALL or its treatment should affect your sex life. But you'll probably go through times when you don’t feel like sex. This might be because you're too tired, or have other side effects of treatment like feeling sick.

It's important to use contraception during treatment and for a period of time after. Getting pregnant while you (or your partner) are having treatment is not a good idea. This is because some of the drugs might harm the developing baby.

Even if you’re using other forms of contraception, you should also use barrier contraception. It is not known whether small amounts of cancer drugs such as chemotherapy is passed on through semen or secretions from the vagina.

Generally, doctors advise using the barrier method such as condoms, femidoms and dental dams. This applies to vaginal, anal or oral sex. 

Advice like this can be worrying, but this does not mean that you have to avoid being intimate with your partner. You can still have close contact and continue to enjoy sex. 

Fertility after ALL treatment

If you haven’t had children you may be worried about your fertility. Most of the treatments for ALL are very 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 or stem cell transplant. Your doctor will tell you if it is likely you will become infertile. If you have a partner, you may want to see your doctor together so that 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

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) Open a glossary itemto reduce menopausal symptoms.

Treating menopasual symtpoms

Your doctor can treat early menopause with hormone replacement therapy. Or another drug called the combined pill Open a glossary item. These can both help reduce menopausal symptoms and replace the hormones you would normally produce such as oestrogen Open a glossary item and progesterone Open a glossary item.

You and your doctor will decide together which is the best for you. HRT and the combined pill helps in preventing long term problems due to the menopause like thinning of the bones (osteoporosis).

You take HRT as a tablet or you can have a skin patch, like a plaster. There are common side effects that you might get from HRT such as:

  • headaches
  • feeling sick
  • tiredness
  • breast pain and tenderness

The combined pill comes as a tablet, skin patch or as a ring that you put inside your vagina. This also comes with common side effects such as headaches, feeling sick, changes in mood, breast pain and tenderness, and weight gain. 

Radiotherapy

Radiotherapy to the area can also affect fertility, this includes total body irradiation (TBI) Open a glossary item. Even small amounts of radiotherapy to the ovaries can stop them from producing eggs. Radiotherapy can also affect the womb so that it is unable to support a baby.

There are ways for women to try to keep their fertility, such as freezing eggs. But unfortunately it isn't usually possible to do this for ALL as treatment often needs to start quickly after diagnosis. Talk to your doctor or nurse about any concerns you may have about your fertility. 

Men and infertility

Chemotherapy

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 might be temporary or might mean you can no longer father a child.

Radiotherapy

Radiotherapy to the area can also affect fertility so that you can no longer produce sperm.

Unfortunately treatment for ALL often has to start very quickly, so it isn't always possible to bank sperm beforehand.

Remember it is important to use contraception during treatment. Becoming pregnant or fathering a child during treatment may affect the developing baby. If you don’t want to have a baby, you should continue to use contraception after treatment until you know for certain that you are infertile.

Coping with infertility

It can be extremely distressing to find out that your leukaemia treatment could stop you being able to have children. It can seem very unfair to have to cope with this as well as your diagnosis. 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 feel sad and come to terms with it.

Talking to other people

Talking to someone close to you is usually helpful, although you might not be able to do this for a while. Help your family and friends by letting them know if you would like to talk about what’s happening and how you feel.

You might want to talk to someone other than your partner, friends or family members. You might find it helps to speak to a counsellor or a therapist. Your doctor or nurse can put you in touch with professional help if you would like it. Don’t be afraid to ask, as it really can help.

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