Sexuality After Transplant
It’s an important and frequently asked question from transplant survivors: when can I return to a normal sex life?
Many transplant survivors experience sexual problems such as a lack of interest in sex, inability to perform and pain. One reason is that chemotherapy drugs, such as Cytoxan or busulfan, as well as total body irradiation reduce hormone levels in the body.
Men's testosterone levels are reduced during transplant and recovery, although they usually return to normal one year after transplant. A reduction in testosterone may result in a decreased interest in sex.
For women, there are also hormone changes. Women who are pre-menopausal prior to transplant usually become menopausal. Pre-menopausal women experience more change in sexual satisfaction following their transplant than women who were menopausal before the transplant.
Some people experience more sexual problems after transplant than others. These include older patients, women, those who had sexual difficulties or lower relationship satisfaction before transplant, and those who do not resume sexual activity within a year after transplant.
Depression is also a major barrier to a satisfactory sexual relationship. Patients with major physical complications such as graft-versus-host disease or those who are in pain will have more difficulty resuming normal sexual relations.
Vaginal dryness is often a side effect of a blood stem cell transplant and may cause pain during sexual intercourse. Seek out the help of a gynecologist or endocrinologist if your are experiencing this problem. Using a water-base lubricant gel or medicated cream prior to sexual activity often helps. Changing sexual positions, doing pelvic exercises and vaginal dilators may also be helpful.
GVHD can cause tightening of the vaginal canal or sores on the vaginal tissues. Cyclosporine is sometimes effective in treating this problem. Surgery may be required if the problem is more severe.
Consider consulting with a sex therapist. These are professionals who are skilled at helping couples regain a comfortable sex life. You can get a referral to a sex therapist from the American Association of Sex Educators, Counselors and Therapists web site or by phoning 1-804-752-0026.