Sex life after anal cancer treatment
Most people can have a normal sex life after having anal cancer. But this depends on what your sex life was like before and what treatment you have had. Your doctor or nurse talk with you about how treatment might affect your sex life before you start.
The side effects mentioned here don't affect everyone who has anal cancer treatment. Some of these effects can get better over time. But occasionally the changes are permanent.
Talking about sex after anal cancer treatment
You may feel embarrassed talking to your doctor or nurse about your sex life and any problems you may have. But remember that they deal with these things all the time, so try not to feel embarrassed. If you tell them about any problems you have, they can find ways to help you manage them.
Your doctor or nurse may be able to offer treatments that can help. And some hospitals have counsellors that are trained to talk about sex after cancer treatment. Your specialist nurse can refer you to this type of service.
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.
You may decide that you want to talk to your doctor, nurse or a specialist counsellor alone at first. And then invite your partner along to a future appointment.
If you are single, you might worry how to tell a new partner about the changes to your body. It can be hard to talk about how certain problems might affect your sex life. A counsellor or sex therapist can help you find a way to do this.
Effects on your sex life
Many people do not feel like having sex while they are having treatment. This can be because of side effects and general tiredness. Try not to worry about this. It is entirely normal and nothing to be concerned about.
Radiotherapy treatment shouldn't stop most people having sex once they feel comfortable. If you’ve had surgery, your surgeon will tell you how long to wait before you have sex again. But it is usually at least 6 weeks after an abdominoperineal resection (APR). This is a large operation to remove your anus, back passage (rectum) and part of your bowel.
Unfortunately, anal cancer treatment can cause side effects that affect your sex life. This can cause sexual problems in both men and women.
Men may not be able to get or keep an erection. And they may have dry orgasms. There are several treatments available for erectile problems.
Women might have dryness and narrowing of the vagina. Your doctor or nurse usually suggest using lubricants and vaginal dilators. Dilators help to stretch the vagina.
Women may also have an early menopause. Your doctor may talk to you about using hormone replacement therapy (HRT) if this happens.
After radiotherapy
Radiotherapy can cause scarring of the anus. This might affect the way your anus works. Some people may have problems controlling their bowels (faecal incontinence) afterwards.
In the long term, radiotherapy can change the lining of the bowel. This can cause some bleeding from the anus. These side effects can make anal sex difficult. But there are treatments that can help. Talk to your doctor if you are worried about this.
After surgery
During an APR, your surgeon removes your anus, so you will no longer be able to have anal sex. This may have a big impact on your sex life.
Your surgeon and specialist nurse talk to you about this before and after your surgery. If you have a partner, sharing your thoughts and feelings with them may help you both prepare for the change. And it may be that you decide to see a counsellor or sex therapist.
Radiotherapy and chemotherapy may both affect your ability to have children (fertility). Your healthcare team talk to you about this before your treatment.
You might find it very difficult to learn that you may no longer be able to have children. There are people you can talk to for support and to help you cope.
Having sex after a colostomy
If you've had a colostomy, you might feel self conscious about the change in your body. You might worry about how it will affect your intimate relationships. Or you may be anxious about practical things, such as the stoma bag being noticeable or smelly during sex.
Stoma bags are well designed. You cannot normally see them under your clothes. But some people may choose to wear a stoma cap during sex. This is a small round bag that just covers your stoma. You can also explore wearing underwear that covers the stoma. Pouch covers for the colostomy bag are also available.
Your stoma bag shouldn't smell. If it does, talk to your stoma nurse. It may be that you need a different type of bag.
Many sexual positions are possible when you have a stoma. The important thing is to find ones that are comfortable for you. Having sex should not hurt your stoma. But it is important not to use a stoma for sex as this can seriously damage it.
Talking with your sexual partner about how you are feeling may help ease your concerns. 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 both need time to feel confident enough to have sex again. And you can still be intimate with your partner through cuddling, kissing and touching until you are ready.
Getting help
There are organisations that offer information and support to help you cope with anal cancer and its treatment. There are also organisations that offer general cancer support and information.
