| Since permanent sterility may occur, it's important
to discuss this issue with your doctor before you begin chemotherapy.
If you wish, you might consider sperm banking, a procedure that freezes
sperm for future use.
Men undergoing chemotherapy should use an effective means of birth control
with their partners during treatment because of the harmful effects of
the drugs on chromosomes. Ask your doctor when you can stop using birth
control for this purpose.
Women
Anti-cancer drugs can damage the ovaries and reduce
the amount of hormones they produce. As a result, some women find that
their menstrual periods become irregular or stop completely while they
are having chemotherapy.
The hormonal effects of chemotherapy also may cause menopause-like symptoms
such as hot flushes and itching, burning, or dryness of vaginal tissues.
These tissue changes can make intercourse uncomfortable, but the symptoms
often can be relieved by using a water-based vaginal lubricant. The tissue
changes also can make a woman more likely to get vaginal infections. To
help prevent infection, avoid oil-based lubricants such as petroleum jelly,
wear cotton underwear and pantyhose with a ventilated cotton lining, and
don't wear tight slacks or shorts. Your doctor also may prescribe a vaginal
cream or suppository to reduce the chances of infection. If infection
does occur, it should be treated right away.
Damage to the ovaries may result in infertility, the inability to become
pregnant. In some cases, the infertility is a temporary condition; in
other cases, it may be permanent. Whether infertility occurs, and how
long it lasts, depends on many factors, including the type of drug, the
dosage given, and the woman's age.
Although pregnancy may be possible during chemotherapy, it still is not
advisable because some anti-cancer drugs may cause birth defects. Doctors
advise women of childbearing age - from the teens through to the end of
menopause - to use birth control throughout their treatment.
If a woman is pregnant when her cancer is discovered, it may be possible
to delay chemotherapy until after the baby is born. For a woman who needs
treatment sooner, the doctor may suggest starting chemotherapy after the
12th week of pregnancy, when the fetus is beyond the stage of greatest
risk. In some cases, termination of the pregnancy may be considered.
Sexuality
Sexual feelings and attitudes vary among people during
chemotherapy. Some people find that they feel closer than ever to their
partners and have an increased desire for sexual activity. Others experience
little or no change in their sexual desire and energy level. Still others
find that their sexual interest declines because of the physical and emotional
stress of having cancer and getting chemotherapy. These stresses may include
worries about changes in appearance; anxiety about health, family, or
finances; or side effects, including fatigue and hormonal changes.
A partner's concerns or fears also can affect the sexual relationship.
Some may worry that physical intimacy will harm the person who has cancer;
others may fear that they might "catch" the cancer or be affected by the
drugs. Many of these issues can be cleared up by talking about misunderstandings.
Both you and your partner should feel free to discuss sexual concerns
with your doctor, nurse, or other counselors who can give you the information
and the reassurance you need.
You and your partner also should try to share your feelings with one another.
If it's difficult for you to talk to each other about sex, or cancer,
or both, you may want to speak to a counselor who can help you communicate
more openly. People who can help include psychiatrists, psychologists,
social workers, marriage counselors and sex therapists.
If you were comfortable with and enjoyed sexual relations before starting
therapy, the chances are that you will still find pleasure in physical
intimacy during your treatment. You may discover, however, that intimacy
takes on a new meaning and character. Hugging, touching, holding, and
cuddling may become more important, while sexual intercourse may become
less important. Remember that what was true before you started chemotherapy
remains true now: There is no one "right" way to express your sexuality.
It's up to you and your partner to determine together what is pleasurable
and satisfying to you both.
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