Your sex life and bowel cancer

Treatment for bowel cancer might mean you have physical changes to your body. This may affect your confidence and how you feel about yourself, intimacy and sex. Talking about how you feel can help you to cope. 

If you have a stoma it can take time to get used to the new changes to your body. Your stoma care nurse specialist will support you. 

Your doctor or nurse can tell you more about how your treatment might affect your sex life. You may feel embarrassed to talk to doctors or nurses about sexual problems. But they deal with these things all the time, so try not to feel embarrassed.

Sex and bowel cancer treatment

You may not think about asking questions to do with sex and relationships at the start of treatment. But it’s something that is important for many people. Your treatment team are used to talking about the impact treatment might have on sex and intimacy.

You should not have sex for at least 6 weeks after major surgery for bowel cancer. But there is no reason why chemotherapy or radiotherapy should stop you having sex if you want to. 

Make sure you use contraception if there is a risk you or your partner could become pregnant. Talk to your specialist about types of reliable contraception before starting treatment. Females with an ileostomy might not absorb the contraceptive pill as well as usual. So you may need to think about different types of contraception.

Many people do not feel like having sex while they are having treatment. Side effects and general tiredness can leave you feeling exhausted. Once treatment has finished you should start to feel stronger and have more energy. 

Some bowel cancer treatments affect your ability to have children (fertility). Your healthcare team should discuss this risk with you at diagnosis. You can get support to help you cope.

Problems with sex after bowel cancer treatment

Sexual problems are quite common in people after treatment for bowel (colorectal) cancer. Surgery to the bowel or back passage (rectum) can affect the nerves to the sex organs. This can cause sexual problems in both men and women. Radiotherapy and chemotherapy can also cause changes which can affect your sex life.

Some men can have problems with getting an erection and ejaculation after surgery and radiotherapy for rectal cancer. You might not be able to get or keep an erection and may have dry orgasms.

There are treatments available for erectile problems.

Pelvic radiotherapy in women can make the tissues in the vagina less stretchy. This is called fibrosis. Fibrosis can narrow the vagina, making it uncomfortable and difficult to have sex.

Radiotherapy can also cause dryness of the vagina, but lubricants can help with this. Trying different positions can help if you’ve had any vaginal changes after treatment. You could try taking time to experiment to see what feels most comfortable for you.

Vaginal dilators after treatment might help to prevent fibrosis. Ask your radiographer, doctor or nurse about dilators.

Sex when you have a stoma

You should wait at least 6 weeks before having sex after surgery to form a stoma. It is a major operation, and it will take time before you start to feel stronger.

Having a stoma can affect how you look and feel. It can take time to come to terms with the new changes in your physical appearance. You might feel anxious or self conscious about having sex. Feeing confident enough to start having sex again can take time. Good communication and taking things slowly can really help.

If you have a partner, talk to them about your feelings. You might find that they too are anxious about hurting you or causing harm to your stoma. Be patient with each other.

If you are single, you might find it helpful to talk to any new partners before having sex about your stoma. This can avoid any awkwardness when you become intimate. Any kind and loving partner should be understanding of your stoma.

Before having sex empty your stoma bag and make sure the new bag is secure. This might help you feel less anxious about any leaks. There are also various accessories available such as cotton covers, belly bands, cummerbunds and caps that can be worn during sex. You can also wear silky underwear or other clothing if you are feeling anxious about your stoma.

Your stoma care nurse specialist can advise you on what accessories are available.

Some people prefer not to use any accessories. This is because they have become more confident with their stoma in time. There is more general awareness of living with stomas now. It could help your confidence to look for social media accounts showing people living with a stoma.

It is important not to use your stoma for sex or insert objects into the stoma. This will damage the stoma and is likely to result in you needing more surgery.

Anal sex

If you have cancer in the rectum, you might have had surgery to remove part of the rectum and anus.

If you used to have anal sex, you will no longer be able to after this type of surgery. This might have a big impact on your life. But your surgeon and specialist nurse will talk to you about this before and after your surgery.

There may be other ways for you to enjoy your sex life. Talking openly about your thoughts and feelings with your partner will help with this.

Getting help

You will probably find that talking things over with your partner can help. It will take time for you to come to terms with all that has happened to you. But sharing how you feel can help.

You may prefer to talk to a specialist counsellor either alone or with your partner if you have one. Your doctor or specialist nurse can put you in touch with a sex therapist if you feel you would like this type of help.