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Some cancer treatments lower the amount of sex hormones in the body or stop the body producing them altogether.
The hormones most commonly affected in women are oestrogen and progesterone. Lower levels of these might affect your sex life.
Symptoms can include:
- a loss of sex drive (also called a low libido)
- vaginal dryness
Loss of interest in sex (libido)
In women, the hormones progesterone and oestrogen play a part in sex drive. But not everyone who has low hormone levels has a loss of interest in sex. For most people, the cause is a combination of factors including:
- your age
- your general health
- stress and worry
- tiredness
- loss of confidence and self esteem
- other side effects of low hormone levels, such as hot flushes
What you can do about low sex drive depends on what is causing it. It is worth thinking about whether any of the factors listed above are relevant for you and if they could be making things worse.
For example, if you are tired, learning how to cope with it or treating the tiredness could help to increase your sex drive. Or it might be something else that is affecting your interest in sex. Do tell your doctor or nurse so they can help.
Vaginal dryness in women
Reduced amounts of sex hormones in women can cause vaginal dryness. This is very uncomfortable and sexual activity can be painful.
Oestrogen helps to maintain the firmness of the wall of the vagina. Without oestrogen the vagina and vulva may become thinner, more easily damaged, and less elastic. The tissues make less of the secretions that help keep the vagina healthy and make sexual intercourse comfortable.
If you have vaginal dryness you might also have itchiness and a discharge.
Lubricants and moisturisers
Non hormone treatments might help. These include moisturisers and lubricants. You put these into your vagina and around the vulva if you need it.
You usually use moisturisers regularly, for example a few times a week. These include Replens or Hyalofemme. The effects last longer than a lubricant.
You use lubricants just before sex as the effects last for a shorter time. These include Vielle, Sylk, Yes, Durex lube and Aquaglide.
Vaginal oestrogen
Ask your doctor about whether you could use vaginal oestrogen if lubricants and moisturisers do not help. These can help to moisturise the vaginal area. You can either use a cream, gel, vaginal ring or pessary. A pessary is a small pellet that you put inside your vagina, where it gradually dissolves.
Your body will absorb some oestrogen, but the amounts are small. It is unclear whether vaginal oestrogens pose a risk for those who have had a hormone dependent cancer, like breast cancer. Research suggests that it does not raise the levels of oestrogen in the blood very much. Talk to your doctor to see if this might be an option for you.
Another treatment for vaginal dryness is a pessary called DHEA. It works in a slightly different way to vaginal oestrogen. Your doctor or nurse would need to prescribe this. It is different to the DHEA supplement available online, which is not licensed for use in the UK.
Hormone replacement therapy (HRT)
One way to help control hormonal symptoms is to take hormones to replace the ones your body is no longer producing. Hormone replacement therapy (HRT) 
is an effective treatment for many women. But some treatments for breast cancer aim to either stop the body producing sex hormones, or block their action. If you are having these treatments, you can’t unfortunately take HRT.
Doctors don’t routinely recommend that you take HRT if you have a hormone dependent cancer, such as breast cancer. Even if you have finished treatment there is concern that HRT may increase the risk of cancer coming back. Talk to your specialist if you are finding it difficult to cope with your symptoms. They can explain the risks and benefits of HRT and if this is an option for you.
Coping
If you are in a relationship, it is important to talk to your partner about how you feel.
Sometimes if you lose your interest in sex it stops you making the effort to enjoy other physical contact with your partner. This can be very difficult for you both. Even if you are not interested in having sex, you can still enjoy physical contact.
Be clear about what physical contact you want
Hugging, cuddling and kissing are comforting and can help you to relax. If you have physical contact it is important to be clear with your partner about how far you are expecting to go.
You might want to put sexual activity on hold for a while. Some people find having other physical contact can gradually lead to them becoming aroused.
What else can affect sex drive?
Some anti depressants can cause a low sex drive. For example, SSRI antidepressants such as Prozac. Talk to your nurse or doctor if you are taking anti depressants and think they may be affecting your sex drive.
Help and Support
If you’re worried about anything to do with your sex life or sexuality, you may want to talk through how you’re feeling. You could do this with a counsellor or therapist. Or you could contact some of the organisations that offer support and information.
