Any cancer surgery – especially one that creates a scar or removes a body part, such as a breast or testicle – may affect your sense of self and body image. This can affect how you feel about your sexuality.
Some surgery in particular may have specific impacts on your sex life.
Learn more about:
Hysterectomy
This removes the uterus and sometimes the cervix. A hysterectomy may shorten the top part of the vagina, but doesn’t change your ability to have sex. The clitoris and lining of the vagina will remain sensitive, so you will usually be able to feel sexual pleasure and reach orgasm. Because there will be no contractions in the uterus during orgasm, sexual pleasure may be affected for some people.
Orchidectomy or orchiectomy
One or both testicles may be removed. If one testicle is removed, there should be no lasting effect on your sex life or fertility. Your remaining testicle should make enough testosterone and sperm to conceive a child. The scrotum’s appearance can be maintained with an artificial testicle (prosthesis).
Having both testicles removed (bilateral orchidectomy), which is rarely required, means you will no longer produce sperm. This causes permanent infertility. You can store sperm before the surgery to use later. Your body will also produce less testosterone, which may affect your sex drive, but this can be improved with testosterone replacement therapy.
Penectomy
Part or all of the penis may be removed to treat penile cancer. The part of the penis that remains may still get erect with arousal and may be long enough for penetration. It is sometimes possible to have a penis reconstructed after surgery, but this is still considered experimental and would require another major operation.
Prostatectomy
This removes the prostate. Side effects may include:
- erection problems
- not ejaculating semen during climax (dry orgasm)
- semen going backwards into the bladder instead of forwards (retrograde ejaculation)
- leaking urine during sex
- loss of pleasure
- pain during orgasm
- penile shortening.
Vagina
A small section of the vagina may be removed to treat vaginal cancer. There should be enough vaginal tissue left for penetration. Some people need surgery that removes the whole vagina (vaginectomy). A vaginal reconstruction may be an option, but after surgery scar tissue can form, making intercourse painful and difficult.
Vulvectomy
Removing part or all of the vulva will change the look and feel of your genital area. This can affect how you enjoy sex and also your body image. If the clitoris has been removed, it may still be possible to have an orgasm by stimulating other sensitive areas (erogenous zones) of your body. It can take time for you and your partner to adjust to these changes (See some tips).
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Dr Margaret McGrath, Head of Discipline: Occupational Therapy, Sydney School of Health Sciences, The University of Sydney, NSW; Yvette Adams, Consumer; Dr Kimberley Allison, Out with Cancer study, Western Sydney University, NSW; Andreea Ardeleanu, Mental Health Accredited Social Worker, Cancer Counselling Service, Canberra Health Service, ACT; Kate Barber, 13 11 20 Consultant, Cancer Council Victoria; Dr Kerrie Clover, Senior Clinical Psychologist, Psycho-Oncology Service, Calvary Mater Newcastle, NSW; Maree Grier, Senior Clinical Psychologist, Royal Brisbane and Women’s Hospital, QLD; Mark Jenkin, Consumer; Bronwyn Jennings, Gynaecology Oncology Clinical Nurse Consultant, Mater Health, QLD; Dr Rosalie Power, Out with Cancer study, Western Sydney University, NSW; Dr Margaret Redelman OAM, Medical Practitioner and Clinical Psychosexual Therapist, Sydney, NSW; Kerry Santoro, Prostate Cancer Specialist Nurse Consultant, Southern Adelaide Local Health Network, SA; Simone Sheridan, Sexual Health Nurse Consultant, Sexual Health Services – Austin Health, Royal Talbot Rehabilitation Centre, VIC; Prof Jane Ussher, Chair, Women’s Heath Psychology and Chief Investigator, Out with Cancer study, Western Sydney University, NSW; Paula Watt, Clinical Psychologist, WOMEN Centre, WA.
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