Sex and chemotherapy Chemotherapy is the injection of chemicals used to treat tumors into the blood system throughout the body through a vein. There is now a new method of chemotherapy that allows both the drug to be injected precisely into the tumor. For example, in patients with bladder cancer, the drug is injected into the bladder through a very thin hose (catheter). Targeted chemotherapy like this has very little effect on the sexual life of female patients. However, if painful intercourse is felt for a short time after treatment, this is due to the inflammatory response of the bladder and ureter caused by the chemotherapy drugs that have not yet healed. Chemotherapy for female patients with pelvic tumors may take the method of pelvic perfusion, which involves injecting a large amount of chemotherapeutic drugs through the nutritive arteries of the tumor. Because this method has been applied for a short period of time, its effect on sexual life is not known. However, it has similar side effects to intravenous chemotherapy for a short period of time. Another chemotherapy method is peritoneal cavity perfusion. In patients with ovarian and colon cancers, liquid chemotherapy is injected into the interstitial space around the intestine and retained for a period of time before being drained out of the body. This method of chemotherapy may cause some degree of discomfort. It is important to consult your doctor and nurse about sex during chemotherapy, such as what to expect during sex during chemotherapy, and how chemotherapy affects sexual function. Pregnancy and fertility during and after chemotherapy If you wish to become pregnant after chemotherapy, it is very important to discuss this with your doctor and inform him/her before chemotherapy. You need to know if chemotherapy affects your reproductive function. Many chemotherapy drugs can damage ovarian function and decrease its hormone production. Sometimes ovarian function can be restored and sometimes it cannot. If you would like to learn more about the effects of chemotherapy on ovarian function, please read the section on “Cancer and Reproductive Function. Female patients should use birth control to prevent pregnancy during chemotherapy. Talk to your doctor about what birth control method is best and safest for you. There are many medications in cancer treatment that can be harmful to your body. If you want to get pregnant, you should consult with your chemotherapist about how long after chemotherapy it is safe to get pregnant. For some female patients, it is still possible to become pregnant after chemotherapy. This is more likely to happen in those younger female patients. So for those female patients who do not want to get pregnant, they should use birth control after chemotherapy. However, it is important to understand that even if you still have your period, it is hard to say that you will be able to get pregnant. Chemotherapy and early menopause Female patients on chemotherapy often have symptoms of early menopause, such as hot flashes, vaginal dryness, vaginal tightness and irregular or amenorrheic periods. Because of the thinning of the vaginal lining, a small amount of bleeding during intercourse may occur. Chemotherapy can also cause outbreaks of genital herpes and genital warts if the female patient has had these diseases in the past. Chemotherapy patients should be seen and receive proper treatment if they have infectious diseases. Because of the immune deficiency caused by chemotherapy, any infection can create serious problems. Mycotic infections can often be prevented by not wearing nylon pantyhose, nylon women’s underwear, or tight underwear. Wearing loose cotton underwear can reduce infection by avoiding moisture around the genitals. After emptying your bladder by urinating, wipe it off with paper from front to back and do not douche. Your doctor may also ask you to use some genital creams or suppositories to reduce mold and other microorganisms around the genitals. Also, it is very important to avoid sexually transmitted diseases because your immune system is depressed during chemotherapy. Safety measures should be taken during every sexual encounter, such as using condoms to prevent contact with body fluids. During any sexual activity, be careful not to allow anything that has touched the perineum to then touch the vagina and urethra. Residual microorganisms from stool entering these areas may cause infection. Chemotherapy and sexual desire Women who are undergoing chemotherapy may find their sexual desire is reduced. Physiological factors, such as nausea and vomiting, weakness and fatigue, reduce sexual desire. Sexual desire is usually restored when the patient feels better. If a female patient has her chemotherapy once every 2-3 weeks, there may be only a few days between chemotherapy treatments when sexual desire is experienced. After chemotherapy is over, the chemotherapy side effects gradually subside and sexual desire gradually returns to normal levels. Chemotherapy patients may have a lowered evaluation of their sexual attractiveness that affects their sex life due to hair loss, weight loss or gain, and indwelling intravenous catheters. Techniques for addressing these issues will be discussed further in later chapters.