Treatment for certain cancers can affect sexuality, causing a range of signs and symptoms that can make sex more difficult. 

Sexual side effects from cancer treatment are common for men and women. Cancer in their pelvic area, including bladder, prostate, rectal, cervical, vaginal or vulvar cancer, can make it difficult to resume sex after treatment. 

"A surgical procedure, especially to the pelvis, can really impact the nerve endings and pelvic muscles that are directly involved in our sexual response," explains Dr. Jennifer Vencill, a Mayo Clinic psychologist and sex therapist. 

Chemotherapy and radiation also can have direct effects on sexual function. Other cancer treatment effects on sexuality may be less direct.

"We see these as a cascade effect of treatment," says Dr. Vencill. "This commonly comes up with loss of libido or decreased desire for sexual activity that could be indirectly related to anything from fatigue to nausea because of chemotherapy to body image concerns. Loss of libido could also be related to pain that has come from a surgery. We see these indirect effects often with our patients."

Having cancer also affects emotions. For instance, people with cancer may feel anxious and worn out about their diagnosis, treatment or prognosis. These emotions also can affect their attitude toward sex and intimacy with a partner.

Dr. Vencill explains that feelings of stress, anxiety and depression are common for cancer patients and their families. 

"In general, psychological and emotional stresses are barriers to sexual health. Of course, cancer and cancer treatment are a major life stressor," says Dr. Vencill.

Dr. Vencill suggests that patience, exploration and support are key to sexual health after cancer.

On the Mayo Clinic Q&A podcast, Dr. Vencill discusses how cancer and cancer treatment can affect sexuality and why it is important to be your own advocate.