What causes sexual problems in women after cancer?

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There are many different causes of sexual functioning concerns in female cancer survivors. Some are physical causes. Others may be due to changes in how you feel about yourself, your body, or other aspects of your life after cancer.

Certain types of cancer, such as those that affect sexual organs, can put survivors at risk for problems. Approximately half of survivors of breast cancer and other cancers that affect the pelvic area (such as the cervix, ovaries, uterus, bladder, colon, or vagina) develop long-term sexual problems. Yet, most problems are actually caused by treatment and not the cancer itself.

Some ways treatment can affect sexual functioning include:
  • Chemotherapy can damage the ovaries, causing hormonal changes and temporary or permanent menopause in younger women.
  • Radiation can affect the vagina, cervix, or uterus.
  • Surgery or radiation therapy can affect cancers in the pelvic area (bladder, colorectal, cervical, ovarian, uterine, vaginal, or vulvar cancer).
  • Side effects of medicines used to treat pain, nausea, depression, or anxiety can affect sexual functioning.
If possible, talk with your healthcare team about the risks for problems with sexual functioning before you begin cancer treatment. There may be things that can be done to minimize risks. If you have already undergone treatment, talk with your doctor about finding ways to treat symptoms or concerns now.

Certain emotions can also contribute to intimacy challenges such as:
  • Sad or depressed feelings
  • Concerns about being less attractive
  • Stress in the relationship with your partner
  • Difficulty with self-esteem because of physical changes
If physical changes affect how a woman feels about herself or her body, this can also contribute to sexual problems. For example, it may be more challenging for someone who was uncomfortable with sexuality or had tension in a relationship before cancer. If you have these types of concerns, ask your doctor for a referral to a licensed counselor who has experience working with cancer survivors.