Sex, sexual health and cancer, a reality for cancer patients that is rarely discussed: "It cost me tears"

"I am not able to sustain an intimate relationship." At a certain point in her life, Yenny Pinzón Cubillos made that confession to her partner, and the reason was not precisely a lack of love: "I can't stand the discomfort."

Yenny, 54 years old, was diagnosed with breast cancer three years ago and underwent chemotherapy. The process, which involves the use of powerful drugs that destroy cancer cells, was necessary to fight the disease, but it had side effects that changed her life.

It's not the only one. In Colombia, thousands of people live with cancer. According to Cuenta de Alto Costo, as of October 31, 2025, 782,868 cases of cancer were documented in the country's health system. A large part of the patients were diagnosed with breast, prostate, colon and rectal cancer, and received their respective treatments.

Although each case is different, side effects usually appear in many patients. Among the best known is, for example, hair loss, which occurs in some people who undergo several chemotherapy sessions. They may also experience fatigue, anemia, nausea, vomiting, diarrhea, weight changes, incontinence, among many other symptoms, according to the American Cancer Society.

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Patients with cancer may experience anemia, nausea, vomiting, diarrhea, weight changes, and other symptoms that arise from the treatments they undergo - credit Jesús Aviles/Infobae But, in addition to all those adverse reactions, there are two key aspects in people's lives that are also affected by treatments against the disease: sexuality, understood as intimacy, and sexual health. This was explained to Infobae Colombia by the doctor and surgeon Alexandra Caballero Guzmán, master's degree in sexual and reproductive health and professor of Oncosexology and Sexology of Palliative Care at the Universidad del Rosario in Bogotá.

Sexual relations: how treatments impact intimacy

According to the expert, some cancer treatments, such as chemotherapy, cause suppression of sex hormones in certain patients, who experience uncomfortable and painful symptoms of which they are not always informed. The decrease of those hormones in women "translates into something that would be like menopause (…). I can have chemotherapy treatments from the age of 14. Therefore, I can be in induced menopause from a very early age. And that is not usually explained to patients".

This is evidenced by the disappearance of menstruation, emotional changes, psychological problems, and decreased sexual desire, something that some men with cancer also face, in addition to erectile dysfunction. Cancer treatments can, in some cases, bring forward symptoms of menopause in women and affect their sex life - credit Gemini/Infobae México

On the other hand, both men and women can suffer from “mucositis”, that is, inflammation, ulceration, and redness of the areas of the body where there is mucosa. In dialogue with Infobae Colombia, Yenny Pinzón detailed what it is about, based on her own experience.

"Those mucous membranes become terribly delicate because they suffer from dryness due to the treatment, and this dryness leads to bleeding, pain, burning, and fissures opening in those mucous membranes (...) My eyes dried up and bled. My nose dried up; it bled. Blisters also appeared in my mouth," she detailed. According to surgeon Caballero, genitourinary syndrome of menopause can also appear in women, a set of symptoms that cause "atrophy" and vaginal dryness. Both the syndrome and mucositis cause discomfort in patients. There is a feeling of discomfort "even to wear underwear", which means that intimacy is also usually ruled out. "To have sexual relations becomes very difficult because it hurts, burns, and one really doesn't want to because, well, one feels a lot of pain (...). You can't even touch yourself, because that burns, it hurts", Yenny specified. Women suffering from cancer and undergoing treatment may present mucositis in their genitals - Illustrative Image credit Infobae/VisualesIA ScribNews Intimacy was suspended for a while with a partner she had at that moment. They talked about the subject and she even showed him how her body was, in order to show why having sex was no longer an option. "I told him, I also showed him, I said: 'Look how I am.' I mean, I am not able to sustain an intimate relationship because I can't stand the discomfort. It's just an impressive pain and annoyance that situation," he explained. Furthermore, according to the recommendations she received from the healthcare staff who treated her, it was best to avoid intimacy during chemotherapy. The body's mucous membranes cannot come into contact with another body, because "the person experiences the same effects as if they were undergoing chemotherapy." Her parents also had a cancer diagnosis, and the three of them faced the disease practically at the same time. So, while Yenny was experiencing the symptoms of this condition, she noticed how her mom and dad were going through similar situations. Men with cancer, who undergo treatments to deal with the disease, can experience painful changes in their bodies due to these treatments - credit Europa Press In his case, sex also disappeared; his father experienced very painful effects that worsened his quality of life and intimacy. "He could no longer have relations with my mom because his penis would swell. It was such an impressive thing (...) It was as if the tip of his penis was going to burst (...), cracks would open," he detailed. The diagnosis of cancer, in itself, can already affect relationships, and the effects derived from the treatments tend to worsen the situation. According to Yenny, in many cases, dating or marriages end because of that. "In the times of chemotherapy, I saw that many husbands abandoned their wives during their treatment. They left them; they would leave the house, the wives would go to chemotherapy, and when they returned, they were no longer there," she specified.

Sexual Health and Self-Perception: "I look in the mirror and I feel sorry for myself"

Diana Laverde, a 47-year-old woman, went through similar experiences. At the time, she was diagnosed with cervical cancer and, to treat it, underwent surgery. Subsequently, she was diagnosed with ovarian cancer; she had her ovaries removed and is currently receiving chemotherapy. The removal of the ovaries generates changes in women's bodies and their well-being - credit Hospital Ruber Internacional/Europa Press

Among the side effects she has faced due to these procedures are hormonal changes, which brought forward the symptoms of menopause. She lives with hot flashes that, in addition to impacting her daily life, make life as a couple difficult. "Right now I don't have a partner; I sleep alone and I say: 'Nobody would tolerate me', because I get hot and then cold," she specified.

Furthermore, due to the surgeries she underwent, her body also changed. She claims to have a "little belly" that is "totally out," which has affected her confidence and comfort when having sex with someone. "It's very ugly. Physically, I look in the mirror and I feel ashamed; I'm ashamed to show my body. Until you can accept yourself comfortably, you think less about intimacy," she said. Additionally, she experienced mucositis in her mouth and perineum, a layer of skin located between the vaginal opening or scrotum (in men) and the anus. "I didn't know I was going to get pimples." The information she received from her oncologist and the health personnel at the oncology center that treated her focused on some effects of chemotherapy, such as dryness in the skin and other parts of the body, but she was not clearly instructed on how to prevent or manage those symptoms. Chemotherapy and other cancer treatments can cause dry skin - credit Fundación Descubre/Europa Press It wasn't until she went to a consultation to explain what she was experiencing that she received guidance on the matter. Then, she was prescribed a cream to heal the lesions and to do mouthwashes and baths with baking soda. However, according to the study “Prevention and treatment of oral mucositis: the effectiveness of sodium bicarbonate versus other agents: a systematic review”, published in the National Library of Medicine of the National Institutes of Health (NIH) of the United States, there is no evidence to support the use of sodium bicarbonate for the management and prevention of oral mucositis, specifically. The patient stated that she had experienced some improvement, although she explained that the use of baking soda is complex because, especially in the vaginal area, it can increase dryness.

On the other hand, in terms of sexual health, health personnel indicated that certain cancer treatments, such as chemotherapy, generate immunosuppression, that is, a weakening of the immune system. Therefore, they recommended avoiding risk scenarios that facilitate the spread of bacterial and fungal infections. That includes sexual relations. Cancer patients are recommended to avoid risk scenarios that facilitate the spread of bacterial and fungal infections - credit Illustrative Image Infobae/VisualesIA ScribNews

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“You have to be careful with sex. One can bleed profusely. So, you have to be careful in intimacy, because sometimes this contact lacerates you and you bleed. It's a very sensitive area,” she explained. Yenny also received half-baked information about everything that would change in her body due to cancer treatment. She was treated by her EPS and in an oncology center where she had training focused, among other things, on the need to increase defenses and on alterations in the mucous membranes. “But they never referred to the genitals and they never touched on intimacy. When it all started happening to me, I said: ‘But what is this?’” she confessed. So, she sought external help. She consulted with an association of women with breast cancer and with the Colombian League Against Cancer, where she received guidance focused on the symptoms she was experiencing, derived from the treatment. Cancer patients should receive guidance on sexual health and intimacy, understood from the effects derived from the treatments - Illustrative Image Credit/VisualsIA ScribNews They prescribed natural lubricants and suppositories to hydrate and regenerate the mucosa. Something completely different from what a gynecologist she consulted about her situation recommended; he sent her conventional lubricants. "Commercial lubricants have parabens. Paraben stimulates the hormonal part and, in my case, which is a hormonal cancer, it immediately triggers the cancerous cells," she indicated. With the right products, it lasted almost a year and a half in treatment to recover the mucosa. "It cost me; it cost me tears, it cost me time, money."

How is it approached from medicine?

The medical expert in oncosexology assures that, in these types of cases, women should use a daily moisturizer and a lubricant to avoid lesions in the mucosa, since those wounds can appear with the use of underwear or with activities such as walking, jogging or cycling. The genitals of women and men can be affected by some cancer treatments. Specialized attention and medicine are required to treat the effects - credit Illustrative Image Infobae/VisualesIA ScribNews For sexual activities, it is indicated that the mucosa is hydrated and flexible, for which a lubricant that does not contain parabens, menthols or alcohols is needed. Special lubricants are required for oncology patients. On the other hand, it is recommended that they go through a rehabilitation phase, which involves pelvic treatment and follow-up consultations for both men and women.

Much more than intimacy: key information for patients

According to Dr. Alexandra Caballero, people with cancer should be properly informed about the reality they are going to face with their treatments, going beyond the results they expect to achieve. It is not only about the limitations that may arise in terms of sexuality and couple life; there are key data related to sexual health that should not be overlooked, but which are often not addressed in consultations.

Chemotherapy, hormone therapy, bone marrow transplant, and other treatments available for cancer patients affect fertility and their immune system. Therefore, it is crucial that patients have preventive guidance, something that, according to what was detailed, does not always happen in Colombia. “Normally, that is not told to the patients”, indicated the doctor Alexandra. The immune system can be weakened by cancer and the treatments to combat it - credit Illustrative Image Infobae/VisualesIA ScribNews

On the one hand, information is provided on measures to prevent pregnancy during treatments. "Patients who are undergoing oncological processes and are going to start this type of treatment must have counseling to prevent pregnancy during treatment, because it can lead to fetal malformations," she explained. Similarly, it should be asked if patients are interested in becoming parents, because there are fertility preservation services they can access before starting treatments against the disease. According to Caballero, a large number of people in Colombia who are of reproductive age have been diagnosed with cancer, which is why it is essential to inquire about their interests in the matter. On the other hand, all people living with this disease should receive information to prevent sexually transmitted infections, because, due to the weakening of defenses, they are more susceptible to acquiring viral infections such as the human papillomavirus (HPV), –some types can cause cancer– herpes and some bacteria. This can complicate their oncological condition. "Patients should be clear about what type of impact the different types of treatments will have on their sexual health," she pointed out. Cancer patients should take extra measures to avoid HPV and other STI infections - credit Illustrative Image Infobae/VisualesIA ScribNews However, in Colombia, the health system lacks a specific care pathway to address the sexual and reproductive health problems of people with cancer. According to Caballero, the Comprehensive Health Care Pathway for Cancer (2018) exists, but the issue of sexual health needs to be adequately integrated. Generally, cancer patients turn to associations that provide services to people with cancer to find answers. “Even though everyone recognizes they are very important, they are ultimately considered accessory, secondary, or tertiary (…) In the midst of the entire oncological process, this is a minor issue. And there is still a taboo about this type of activity (sexual life),” she detailed. For women, the approach is much more complex, because oncologists do not usually have training in sexuality, and gynecologists do not always have specialized knowledge in oncology. Interdisciplinary management is required. From urology, the effects derived from cancer treatments are addressed, but men also require specialized attention in sexuality and oncology - credit Illustrative Image Infobae/VisualesIA ScribNews

In the case of men, according to the expert, "they have more help" because they are seen by urologists who "handle erectile dysfunction supremely well" – which is treated with medications, injections, and devices that help oxygenate the corpora cavernosa – and other symptoms. However, they must also have health care that does not ignore their cancer diagnosis.

Psychological accompaniment: an approach that should not be overlooked

As explained to Infobae Colombia by psycho-oncologist Mayra Alejandra Vaca, who has more than 10 years of experience in accompanying cancer patients and their families, all the effects of cancer and treatments not only generate physical changes; they affect people's mood, causing stress, fear, anxiety, shame, guilt, sadness, among others. That combination also impacts the sexual desire of patients, who, like anyone else, need security, connection, and a feeling of general well-being to have sexual desire and experience truly pleasurable sexual encounters. The shock is such that people living with the disease report having lost their sexual identity. "In breast cancer treatments, it is very common for a decrease in desire to occur (...). There is a fear of not being able to connect again with their partner or of not being liked or of not feeling that confidence so that the partner can see them," explained the expert. Psychological support is key for cancer patients, in order to improve their quality of life - illustrative image credit Infobae/ People who experience weight changes due to illness or treatment, or who undergo mastectomies (surgical removal of one or both breasts), ostomies (surgical opening in the abdominal wall to allow waste removal), also experience difficulties in living their sexuality.

In addition to this, there is hair, nail, and skin loss, according to Yenny Pinzón. “They also cause a disconnection in the sexual part”, detailed the psycho-oncologist.

Therefore, in addition to having professional support from oncology and sexology, cancer patients need psychological support, which focuses on how to assume the reality of the disease and its consequences, as well as the emotional challenges that couples experience, in certain cases. “Helping them how to establish new forms of intimacy, not only penetrative, but to explore, for example, caresses, hugs or other type of bond”, the expert specified. From psychology, it is possible to delve into the reality faced by some couples when one of them is an oncology patient - Illustrative Image credit Infobae/VisualesIA ScribNews Psychoeducation, aimed at explaining the stage they are going through and the symptoms they are experiencing, is crucial to reduce the stress they feel. "Many times doctors have not explained very well all those effects it has on sexuality and there is a lot of uncertainty, a lot of doubt. Many times they ask themselves: 'Is it, is it me? What's happening to me?'", he indicated.

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And the fact that, in many cases, couples become the caregivers of the patients cannot be left out, which can imply an emotional shock due to the change of roles and an overload, due to the amount of activities they must assume. “Many times the couple begins to have difficulties precisely because there is no differentiation between being the caregiver and continuing to be a couple”, she explained, specifying that this situation exacerbates pre-existing problems in couples. Hence the importance of having psychological support, in which the work, academic, couple, family and sexual aspects are evaluated, since they are vital areas of the human being.