Talking to Your Oncologist About Sexual Health: Questions to Ask

When facing a cancer diagnosis, discussions typically center around treatment options, survival rates, and managing side effects like nausea or fatigue. Yet one crucial aspect of wellbeing—sexual health—often remains unaddressed in the oncologist’s office.

Research published in the Journal of Clinical Oncology reveals a startling disconnect: while 75.8% of oncologists believe addressing sexual function is their responsibility, over 80% discuss it with fewer than half their patients. Meanwhile, up to 90% of cancer survivors report some form of sexual dysfunction following treatment.

“This silence creates unnecessary suffering,” explains Dr. Jennifer Barsky Reese, sexual health researcher at Fox Chase Cancer Center. “Many patients don’t realize their sexual concerns are valid medical issues that can often be addressed with proper intervention.”

This guide aims to bridge that communication gap by providing you with specific questions to ask your oncologist about sexual health—before, during, and after cancer treatment.

Why Sexual Health Discussions Matter

Cancer and its treatments can impact sexual health through multiple mechanisms:

• Physical changes: Surgeries may alter sexual anatomy or nerve pathways
• Hormonal effects: Many treatments disrupt hormone production
• Psychological impact: Body image concerns, anxiety, and depression affect desire
• Relationship dynamics: Changing roles between partners during illness

According to the Oncology Nursing Society, addressing these concerns early can significantly improve quality of life during and after treatment. Yet patients and providers alike often hesitate to initiate these conversations.

Overcoming the Conversation Barrier

If you’re feeling uncomfortable about discussing sexual health with your oncologist, you’re not alone. Here are some approaches that can help:

• Remember it’s medical: Sexual function is a health issue, not just a personal matter
• Write questions down: Bring a prepared list to ensure your concerns are addressed
• Use direct language: Clear, specific questions get better responses
• Consider timing: Schedule a dedicated appointment if needed
• Bring support: Having your partner or a trusted friend present may help

Dr. Michael Krychman, sexual medicine specialist, suggests: “Frame your questions in terms of quality of life. For example, instead of asking ‘Will I still enjoy sex?’ try ‘How might treatment affect my sexual function and what options exist to address potential problems?'”

Key Questions to Ask Before Treatment Begins

The pre-treatment phase is ideal for proactive discussions about sexual health. Consider asking:

General Questions

1. “How might my specific cancer and planned treatments affect my sexual health in both the short and long term?”
2. “What percentage of patients with my diagnosis experience sexual side effects?”
3. “Are there alternative treatments that might have fewer sexual side effects while maintaining effectiveness against my cancer?”
4. “Should I consult with a sexual health specialist before beginning treatment?”
5. “What preventive measures can I take now to minimize sexual side effects later?”

For Women

6. “Will treatment affect my hormonal levels, and how might this impact sexual function?”
7. “Is there a risk of premature menopause from my treatment plan?”
8. “Should I consider vaginal moisturizers or dilators during treatment to prevent vaginal stenosis?”

For Men

9. “What is the likelihood of erectile dysfunction with my treatment plan, and is it likely to be temporary or permanent?”
10. “Should I consider banking sperm before treatment begins?”
11. “Are there medications I should start taking preventatively to maintain erectile function?”

Questions During Treatment

As you progress through treatment, new concerns may arise. Regular check-ins about sexual health should be part of your care:

1. “I’ve noticed [specific change in sexual function]. Is this related to my treatment, and how should I address it?”
2. “Is it safe for me to be sexually active during this phase of treatment?”
3. “Are there any precautions my partner and I should take during sexual activity while I’m undergoing treatment?”
4. “How long after this treatment session should I wait before engaging in sexual activity?”
5. “Could my medications be adjusted to reduce sexual side effects without compromising my cancer care?”

According to a Moffitt Cancer Center publication, patients who discuss sexual health during treatment report less anxiety and better quality of life, regardless of whether they’re currently sexually active.

Questions After Treatment Completion

The post-treatment phase brings its own set of concerns as you adjust to your “new normal”:

1. “Now that my treatment is complete, what sexual changes might I continue to experience, and which ones might improve?”
2. “What is the typical timeline for sexual function recovery after my type of treatment?”
3. “What options do I have if my sexual function doesn’t return to my pre-cancer baseline?”
4. “Are there specialists you recommend for ongoing sexual health support?”
5. “What warning signs should prompt me to seek medical attention regarding my sexual health?”

Cancer-Specific Sexual Health Concerns

Different cancer types and treatments come with specific sexual health considerations:

Breast Cancer

Breast cancer treatments can cause premature menopause, vaginal dryness, and body image concerns. Specific questions include:

• “How will hormone therapy affect my libido and vaginal health?”
• “What options exist for managing vaginal dryness that won’t interfere with my treatment?”
• “Can you refer me to resources for addressing body image concerns after mastectomy or reconstruction?”

Prostate Cancer

Men with prostate cancer often experience significant changes to sexual function. Consider asking:

• “What are the comparative sexual side effect profiles of surgery versus radiation for my stage of prostate cancer?”
• “What is the success rate of nerve-sparing techniques in preserving erectile function?”
• “When should I begin penile rehabilitation after treatment, and what does this entail?”

Gynecologic Cancers

Treatment for ovarian, cervical, or uterine cancers can dramatically affect sexual anatomy and function:

• “How will surgery or radiation affect the length and elasticity of my vagina?”
• “What can be done to preserve vaginal function during and after treatment?”
• “How soon after treatment can I safely resume sexual activity?”

Colorectal Cancer

Colorectal cancer treatments can affect both physical function and body image:

• “How might an ostomy affect my sexual function and positioning during intimacy?”
• “What resources exist for managing intimacy with an ostomy?”
• “Will nerve damage from surgery affect my ability to achieve orgasm?”

When Your Oncologist Doesn’t Have All the Answers

It’s important to recognize that not all oncologists have specialized training in sexual health. If your doctor seems uncomfortable or unable to address your concerns fully, consider asking:

1. “Can you refer me to a sexual health specialist who works with cancer patients?”
2. “Is there a sexual medicine clinic associated with this cancer center?”
3. “Are there support groups specifically addressing intimate relationships during cancer treatment?”

According to UPMC Cancer Center, a multidisciplinary approach often works best, potentially including:

• Sexual health physicians
• Pelvic floor physical therapists
• Sex therapists or counselors
• Fertility specialists
• Psychological support services

Including Your Partner in the Conversation

Cancer affects not just the patient but also their intimate relationships. When appropriate, including your partner in sexual health discussions can be beneficial:

• “What resources do you recommend for my partner to understand how my treatment might affect our intimacy?”
• “Are there specific concerns my partner should be aware of regarding my treatment and our sexual relationship?”
• “Can you suggest ways we might maintain intimacy during periods when traditional sexual activity might not be possible?”

Dr. Leslie Schover, founder of Will2Love, notes: “Partners often have questions they’re afraid to ask because they don’t want to seem selfish. Having them present for these discussions validates their concerns and helps them become better supporters.”

Advocating for Your Sexual Wellbeing

If you encounter resistance or dismissal when raising sexual health concerns, remember:

• Sexual wellbeing is a legitimate aspect of quality of life during and after cancer
• You have the right to have your concerns addressed
• If your current provider isn’t responsive, seeking a second opinion is appropriate

As one breast cancer survivor shared with This Is Living With Cancer: “I had to be persistent. My first oncologist brushed off my concerns about intimacy, but when I switched to a comprehensive cancer center, sexual health was actually part of their standard assessment. The difference in my quality of life was tremendous.”

Conclusion: Breaking the Silence

Sexual health remains one of the most undertreated aspects of cancer survivorship, largely because of communication barriers between patients and providers. By preparing specific questions and approaching the topic as the legitimate medical concern it is, you can advocate effectively for this important dimension of your wellbeing.

Remember that recovery of sexual function—like other aspects of cancer recovery—takes time and sometimes requires specialized intervention. The first step is starting the conversation with your oncologist using the questions outlined in this guide.

Have you discussed sexual health concerns with your healthcare provider? What approaches worked well for you? Share your experiences in the comments below to help others navigate these important but difficult conversations.