Colorectal cancer and its treatment affects people in different ways. Sometimes it can change your ability to enjoy or have sex. This is called 'sexual dysfunction', and can include:
- Dyspareunia (difficult or painful sex)
- Less interest in sex
- Not being able to get or sustain an erection (erectile dysfunction)
- Taking longer to achieve orgasm
- Having an orgasm without any semen or with urine instead of semen (ejaculation problems)
These problems can often be treated and managed.
Sexual dysfunction often involves the need to talk to your partner, see the resources under "More information" below.
Surgery - Abdominoperineal resection
Abdominoperineal resection is surgery to remove the lower colon, rectum, and anus. During this surgery, the surgeon creates a stoma (artificial opening) in the abdominal wall that allows stool to leave your body. This procedure is called a colostomy. A special bag or pouch (colostomy bag) is attached to the stoma to collect food waste from the colon.
Many people can reach an enjoyable sex life while living with a stoma- it may just take some adjustment and planning.
Some peoples’ sexual preference includes anal intercourse. If you have had colon cancer, there is no restriction with respect to anal intercourse. If you have had rectal cancer, anal intercourse may be traumatic to the colorectal anastomosis (reconnection). You should discuss this with your surgical oncologist (cancer doctor who performed your surgery). Your recommendations will depend on the details of the surgery you had, how much time passed from your surgery, and your overall treatment.
Radiation and Chemotherapy
Radiation and chemotherapy can cause some side-effects on sexual function for both men and women.
For men, radiation to the pelvis can cause problems with erections. About 40% of men who have had no erectile problems before their cancer treatment, can develop impotence or erectile problems as a result of radiation.
For women, radiation can cause:
- Vaginal dryness
- Vaginal stricture (tightness)
- Dyspareunia (difficulty or painful sex)
- Bleeding during sex
- Early menopause
For women, some types of chemotherapy can also cause early menopause.
Some men and women may lose sexual desire (libido) due to fatigue from cancer treatment. Generally, changes in energy levels are not permanent, and many people regain their ability to enjoy their sex life.
See also: Fatigue - Getting Back On Track After Colorectal Cancer »
Sexual problems, which may be caused by treatments or by psychological reactions and mood, often fall into one of four categories:
- Libido (sex drive) or desire disorders, which is the decrease or loss of sexual fantasies and desire
- Arousal disorders, which include the inability to achieve or maintain sexual arousal, such as lubrication or swelling
- Orgasmic disorders, which is the delay or absence of orgasm following normal arousal
- Pain disorders, which is genital pain during sexual intercourse
In colorectal cancer survivors, sexual dysfunction differs based on the type of cancer treatment(s) you have had. Sexual dysfunction can also result from the stress and negative emotions about having cancer.
What your doctor will do
Sexual health is part of overall health and healing. You can talk to members of your health care team about your concerns.
What you can do
For detailed ideas about what you can do, see the resources under "More information" below.