Body image and sex

Cancer and its treatment may affect your body image.  It can also affect your emotions and relationships, which can lead to issues with intimacy, and side effects of treatment may also affect your ability to have sex.

This webpage has information and advice around coping with these changes and the healthcare professionals that can help.

Body image

You may have side effects of treatment that make you feel self-conscious or affect your confidence. You may feel sad, angry or worried about any changes to your body. It can be difficult to stop thinking and worrying about how you look or what other people think. People of any age or gender can feel differently about their body with or after cancer.  

Here are some things that might help: 

• Talking about how you feel can help you cope. You could talk to someone close to you or you could speak to your specialist nurse  
• Spending time around people who make you feel good about yourself can boost your confidence 
• You may find it useful to look in the mirror and focus on the parts of your body you do like
• You could write down reasons you like your body or reasons you are grateful for it 

If you have a stoma, you may have strong feelings about the sudden and significant change to your body. Your stoma care nurse specialist can help you to adapt to your new body. Remember that family, friends and healthcare professionals are there to help you. 

It can take time to get used to managing your stoma. Your stoma care nurse specialist can help you with any worries you may have. Having a stoma should not stop you doing the things you enjoy. Lots of shops and companies sell underwear, swimwear and other products for people with stomas that can help you feel more comfortable. 

Lots of people post on social media about living with a stoma. Some people find comfort by following their journeys. 

Our stoma support Facebook group is a supportive place for those who either have a stoma or are considering one as treatment for bowel cancer. The group is a safe space to ask questions, share experiences and give and receive support. 

Sex

Many people find it embarrassing to talk about their sex lives but your healthcare team are used to answering questions and talking openly about sexual matters, so don’t hesitate to ask them questions and talk about this with them if you want to.  

If you want to be sexually active or want to start a new relationship, there are professionals who can help. Whether or not you have a partner, a psychosexual therapist can also help you to understand and come to terms with any sexual problems.

Erections and ejaculation

If you have a penis you may have problems getting an erection or problems with ejaculation after having surgery or radiotherapy.

During radiotherapy, you may find that ejaculating is painful. This is because radiotherapy can cause irritation and swelling (inflammation) of the urethra. The urethra is the tube that carries wee (urine) and semen out of the body.

If you are finding ejaculation painful you should avoid having sex. This side effect usually goes away a few weeks after you finish your radiotherapy treatment.

If you've had surgery or radiotherapy around your rectum you may have problems getting and keeping an erection. These problems may get worse a few months or years after radiotherapy finishes.

Possible treatments include tablets that increase blood supply to the penis, injections to help you get an erection, pellets that you insert into the end of the penis, vacuum pumps and penile implants.

These treatments might not be suitable for everyone and some people choose not to have treatment. The success of the treatment will depend on whether the nerves or blood supply to the penis have been affected by the cancer treatment.

Vaginal narrowing and dryness

Surgery and radiotherapy can cause the vagina to become narrower or shorter. The vagina might be drier than usual or less stretchy. This can make sex difficult and painful.

You can try having sex in different positions to find what is most comfortable for you. Using lubricants can help with vaginal dryness. Having regular sex or using a tool like a dilator can help to reduce the risk of vaginal narrowing.

Hormones and menopause

Some chemotherapies and radiotherapies affect how the ovaries work. This can reduce the amount of hormones the ovaries produce and lead to early menopause. This may be temporary or permanent. 

Symptoms of the menopause can affect your sex life and how you feel about sex. Symptoms might include:

• loss of interest in sex (low libido)  

• vaginal dryness  

• hot flushes and sweats  

• mood swings  

• trouble sleeping 

Anal sex

If you've had surgery to remove part of your rectum or anus you will no longer be able to have anal sex. If you have had surgery on other parts of your bowel you may find anal sex painful or difficult and in some cases it can be dangerous. 

This may have a big impact on your sex life. There are other options to help you enjoy your sex life. You can speak to your healthcare team about these, they are there to help you and answer any questions you may have.

Sex when you have a stoma

You may not feel ready to have sex after surgery or when living with a stoma. You may want to get used to having a stoma first. Give yourself time to recover and get used to the changes to your body.

If you have a partner, it can help to speak with them about how you’re feeling. They may be feeling anxious too and you can be open about your feelings together.

You should never do anything sexual that directly involves your stoma. This is very dangerous and can lead to infection or permanent damage.

You don’t need to wear a special stoma bag to have sex, but you can get smaller stoma bags if you choose to.

You may want to change your stoma bag before you have sex so that it’s empty. You can also use stoma support bands (cummerbunds) to support or hide your stoma bag.

You can buy underwear that is especially designed to be worn with a stoma bag. This may help you feel more confident.

If you feel you need help with any sexual problems, ask your GP or healthcare team to refer you to a sexual health specialist or psychosexual therapist. 

More information

Visit our online community to talk about your experiences, share knowledge and get support from other people.

The Colostomy UK website has a list of companies that sell products for people with a stoma. 

Macmillan Cancer Support provides information on how cancer treatment affects the way your body looks, works or feels.  

Shine Cancer Support offers videos and podcasts with advice on sex and relationships for people living with cancer.

Menopause and Cancer give support and advice to people going through the menopause brought about through cancer treatment.  

Relate.org give advice for couples about talking about their relationship. They can provide counselling and psychosexual therapy.  

OUTpatients provide information about all aspects of sex for anyone with cancer.  

Updated July 2026 

Next review July 2029