Dear Dame: I'm Worried about Chemo Affecting my Libido

Dear Dame: I'm Worried about Chemo Affecting my Libido

Created on 05/04/2023
Updated on 05/04/2023
Dear Dame is a weekly sex-positive and judgment-free advice column answered by our panel of sexperts. Submit your questions here.


"Dear Dame,
I am about to start chemo treatments and I’m really worried about it impacting my libido. Everything I’ve read says that it messes with your hormones and you won’t feel like having sex. Sex is one of the main ways I feel connected to my partner, though. How can we keep our physical intimacy intact while I’m in treatment?

Dear Anonymous,

There's tremendous energy and vibrancy in radioactivity, along with some challenges. When one is being treated for cancer and chemo they have the opportunity to be creative, and open up a conversation in your intimate life that's new, and different, and provocative, and pleasurable. 

The first step is to know your own body and, most importantly, attend to your own body as you're going through chemo. And communicate! If your partner hasn’t been through this themselves then they won't know what you're experiencing or what you're feeling other than perhaps the obvious issues unless you tell them. For example, if you're losing hair or you're nauseated or you're fatigued, those physical challenges are obvious but impact people differently. There are some people who experience hair loss as a very great challenge and for others, it can be freeing and even an interesting experiment for them. So, again, just continually communicating with your partner about how the experience is affecting you or what you're worried about in anticipation of it. 

Instead of seeing the time that you get chemo as a time of failure or permanent limitations, envision opportunity. Find intimacy and pleasure in new ways. So the first step is to discuss the kind of chemo you're getting with your oncologist. What can be expected? What might be typical? How might it affect your erotic zone, sex organs, hormones? In women it might create menopause and the challenges or sequelae of  menopause that are new or different if you're a young woman. So find out, get information. Does that necessarily mean you will experience all these things? No. But the more you can be aware, and the more empowered you are with information, the more you can anticipate and prepare. Having that knowledge can help you address the different impacts, whether it's mood and libido, or the physical changes to erogenous zones like the penis, the vagina, the breasts. Again, having as much information about how the chemo will affect you will empower you. 

Moreover, if chemo was following surgery, please let your body heal from the surgery first. And remember that pleasure can arise just through touch, conversation, sharing imagery, erotica, massage. There are so many other ways in which we can be intimate with our partners. It doesn't have to be the old, so-called “scripted” way in which you've made love before.

Sex is safe with chemo. But there are issues that we don't completely understand. So you have to prevent pregnancy, you have to make sure that you are taking care of any exposure to infection, and you want to avoid exposing your partner to the chemotherapy in body fluids, vaginal and semen. Scientists are beginning to suggest that you wait 48 to 72 hours after treatment to reduce this risk. But no one really knows just how much chemo is passed to the partner. So use condoms for vaginal or anal sex and dental dams for oral sex. Taking these precautions can assist both in staying safe and healthy. 

I can't stress enough the intimacy that can be had with conversation and talking about where you're at, supporting each other, discussing how to stay intimate and give each other pleasure. And remember, it's only probably a temporary interruption to your sex life. It’s not necessarily permanent and there are folks out there who can help — sex therapists, couples therapists, erotic products. Look to Dame for products that can stimulate the external body parts. Not necessarily penetrative to protect mucous membranes. And just giving your partner permission to use the sex toys and pleasure themselves. It is good to know chemo can make you feel less sexy. But that doesn't mean that you're a less sexual human being. And again, this is probably a temporary situation. And an opportunity for you to explore new conversation, new products, new ways of being with your partner.

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