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Side Effects of Chemotherapy and Radiation Therapy on Sexuality and Fertility

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4 min read


Chemotherapy, radiotherapy, and surgical therapy are the most common cancer treatment techniques. Read this article to understand whether it is a boon or a bane.

Medically reviewed by

Dr. Raveendran S R

Published At November 25, 2022
Reviewed AtMay 11, 2023


The cells in our bodies divide regularly, but cancer cells divide unnaturally, and the newly formed cells are nonfunctional. Chemotherapy and radiotherapy are employed to kill these cells that are no longer functioning and have been produced abundantly. However, other fast-growing cells in our bodies are also destroyed, resulting in the adverse effects of these treatments.

What Are the Most Common Chemotherapy and Radiation Therapy Side Effects?

Chemotherapy and radiotherapy have similar side effects, ranging from mild fever to severe consequences. The adverse effects may appear immediately or build over time as the treatment progresses.

Some of the side effects of these cancer treatments are listed below:

  • Common Cold-Like Symptoms - Some cancer drugs activate the body's natural inflammatory response, resulting in common cold-like symptoms.

  • Oral and Dental Problems - Normal salivary flow is necessary for maintaining oral and dental health. However, xerostomia develops in persons undergoing chemotherapy or radiotherapy, leading to increased dental and oral issues.

  • Radiation Recall - Refers to skin issues that arise during and after treatment.

  • Hair loss, anemia, coagulation issues, gastroesophageal illnesses, and infertility are all common side effects of chemotherapy and radiotherapy-induced cell destruction.

What Are the Adverse Effects of Chemo and Hormone Therapy on Male Sexual Dysfunction?

  • Erectile Dysfunction.

  • Low sex drive.

  • Ejaculatory dysfunction.

  • Gynecomastia.

  • Penile and testicular atrophy.

What Are the Adverse Effects of Radiation Therapy on Male Sexual Dysfunction?

What Are the Adverse Effects of Surgical Therapy on Male Sexual Dysfunction?

  • Urinary issues.

  • Incompetence.

  • Pain near the operated site.

  • Retrograde ejaculation.

  • Disturbed body image.

What Are the Adverse Effects of Chemo and Hormone Therapy on Female Sexual Dysfunction?

  • Disturbed menstrual cycle.

  • Early menopause.

  • Vaginal dryness.

  • Dyspareunia (painful sexual intercourse).

  • Decreased libido.

What Are the Adverse Effects of Radiation Therapy on Female Sexual Dysfunction?

  • Vaginal atrophy.

  • Pelvic fibrosis.

  • Decreased lubrication.

  • Decreased elasticity.

  • Vaginal ulceration.

What Are the Adverse Effects of Surgical Therapy on Female Sexual Dysfunction?

  • Pain near the operated site.

  • Disturbed body image.

  • Loss of nipple.

  • Decreased vaginal size or sensitivity.

  • Bowel changes.

What Variables Influence Infertility Caused by Chemotherapy and Radiotherapy?

Fertility changes in cancer-treated patients are determined by a variety of factors, including:

  • Current baseline fertility or infertility issues.

  • The type of cancer.

  • The affected site.

  • The type of treatment opted for chemotherapy, radiotherapy, or surgery.

  • The duration of treatment.

  • The dose of the drug used or the radiation used in therapy.

How Does Chemotherapy or Radiotherapy Increase the Risk of Infertility in Males or Cause It?

Chemotherapy and Radiation therapy are aimed at hyperactive cells, which also destroy various functional cells in the body.

  • Chemotherapy can harm the germ cells (sperm-forming cells), which can, in turn, reduce sperm production.

  • Infertility can be caused by radiation therapy to the reproductive organs and radiation near the abdomen, which lowers sperm counts and testosterone levels. In addition, radiation can kill sperm cells and the stem cells that produce them.

  • Radiation therapy to the brain can harm the pituitary gland, reducing testosterone and sperm production.

  • Infertility can result from surgery for tumors of the reproductive organs and pelvic cancers, which can harm these organs and adjacent nerves.

  • High doses of radiation are used in stem cell transplants, such as bone marrow transplants and peripheral blood stem cell transplants. However, these procedures can damage sperm and sperm-forming cells.

How Does Chemotherapy or Radiotherapy Increase the Risk of Infertility in Females or Cause It?

  • Chemotherapy can cause temporary or permanent infertility in women.

  • Chemotherapy can cause primary ovarian insufficiency, which impacts the ovaries, leading them to stop producing eggs and the hormone estrogen.

  • A drop in the estrogen hormone level can affect the quality of the eggs in the ovaries.

  • Women above thirty-five are at high risk of infertility, approaching an average menopause age.

What Alternatives Do Men Have for Preserving Their Fertility?

Four fertility preservation treatments are all readily available at fertility clinics for men:

  • Sperm Cryopreservation - Sperm banking or semen cryopreservation is the most common and straightforward alternative. Men of reproductive age undergoing cancer therapy can opt for this. In the laboratory, semen samples are collected and examined under a microscope. The sperm is then frozen and saved for future use.

  • Gonadal or Testicular Shielding - When the regions of the body surrounding the testes are being treated with radiation, testicular shielding can be done. Gonadal shielding is a process in which a protective cover is placed on the body's exterior to screen the testicles from scattered radiation to the pelvis.

  • TESE (Testicular Sperm Extraction) - Males who cannot produce a sperm sample undergo testicular sperm extraction (TESE). A medical process that includes collecting sperm and preserving it for future use.

  • TTF (Testicular Tissue Freezing) - Most hospitals still consider testicular tissue freezing (also known as testicular tissue cryopreservation) an experimental operation. This surgery may be possible for males who have not reached puberty and are at high risk of infertility.

What Alternatives Do Women Have for Preserving Their Fertility?

  • Oocyte Cryopreservation - Egg freezing or oocyte cryopreservation is a process that involves removing and freezing the ovary eggs. These preserved eggs can be used for in vitro fertilization procedures in future life.

  • Embryo Freezing or Embryo Banking is a cryopreservation procedure for saving eggs for the future.

  • Ovarian Shielding (Also Known as Gonadal Shielding) - Similar to testicle shielding, it is a process in which a protective cover is placed over the ovaries and other elements of the reproductive system on the outside of the body to prevent them from scattering.

  • Oophoropexy is a procedure that involves transposing the ovaries away from the body area exposed to radiation.

  • Radical Cervicectomy is a procedure to treat women with early-stage cervical cancer who want to start a family. The cervix, surrounding lymph nodes, and the top section of the vagina are all removed during this procedure. The uterus is then joined to the remaining vaginal wall with a specific ring that acts as the cervix.


It is essential to link cancer treatment and sexual dysfunction or infertility. Because it is not always feasible to foresee how the body will respond to treatment, there are no apparent reasons for cancer therapy to induce or elicit specific side effects. Younger people and cancer survivors should always take steps to preserve their fertility, as sexual health is linked to overall health.

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Dr. Raveendran S R
Dr. Raveendran S R



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