Sexual health side effects in young adults

An important part of managing side effects that impact your sexual health is to determine what factors may be causing or contributing to the changes you are experiencing, so that you can address them.

Lack of desire

The following can contribute to lack of desire: 

• Anxiety or depression
• Fatigue
• Pain or discomfort
• Nausea
• Body image concerns
• Hormonal changes, including early menopause
• Some medications

It’s important to address the issues that may contribute to lack of desire. If hormonal changes are causing lack of desire, hormone therapy may help.

• Estrogen therapy: Some chemotherapy drugs and radiation to the pelvis can cause the ovaries to produce less estrogen. Estrogen therapies come in the form of pills, creams, patches, and vaginal rings. (For patients with a history of hormone-driven breast, ovarian, or uterine cancer, estrogen therapy may not be safe.)
• Testosterone therapy: Some chemotherapy drugs and radiation to the pelvis can cause the testicles to produce less testosterone. Testosterone therapies come in the form of injections, pills, patches, and gels. (For patients with a history of prostate cancer, testosterone therapy may not be safe.)

Non-hormonal therapies may also be helpful. Talk to your doctor about your options.

Erectile disorder

Erectile disorder, also called erectile dysfunction (ED), can be a side effect of cancer treatment. The cause of ED can be either mental or physical. Your doctor can help you determine the cause. If the cause is physical, medication or other therapies may help:

• Prescription phosphodiesterase-5 (PDE5) medications, such as Sildenafil (Viagra®) or Tadalafil (Cialis®)
• Penile injections
• Vacuum constriction device (or pump)

Note: Over-the-counter (OTC) products and supplements claiming to help with ED or improve sexual performance may not be safe or effective. Talk to your doctor before trying any of these products.

Vaginal dryness

Vaginal dryness is often related to a decrease in estrogen levels, so systemic or localized estrogen therapy may help.

Other options to improve vaginal dryness include:

• Using a lubricant during sex: Use unscented, water-based, or silicone-based lubricants. Oil-based lubricants can break down condoms and dental dams. Scented, flavored, and warming lubricants can irritate the vulva and vagina.
• Vaginal moisturizers: If used regularly, they improve overall dryness and vaginal health.

Early induced or premature menopause

Menopause, the end of menstruation, is caused by a natural decline in reproductive hormones, and typically occurs in people who are between 45 and 55 years of age. Some chemotherapy drugs and radiation to the pelvis can cause the ovaries to produce less estrogen. The decrease in estrogen levels can cause interruptions or changes to the menstrual cycle, including early menopause.

Even if the menstrual cycle does not change, estrogen levels may be lower than before treatment. For some patients, their menstrual cycle may return after treatment ends. Symptoms of menopause and/or low estrogen levels can include decreased sexual desire and vaginal dryness. 

Menopause does not mean the end of sexual desire, pleasure, and intimacy. Many people continue to have fulfilling sex lives after menopause. Estrogen therapies can help address the symptoms of menopause. 

Estrogen therapies (alone or in combination with progesterone) come in pills, creams, patches, and vaginal rings. If you have a history of hormone-driven breast, ovarian, or uterine cancer, estrogen therapies may not be safe for you. Talk to your doctor about your options. 

Learn more about sexual health and intimacy after receiving a blood cancer diagnosis.