Sexuality, intimacy and relationships
What are sexuality and intimacy?
Sexuality and intimacy mean different things to different people.
Sexuality and intimacy are closely connected to your sense of self and sense of wellbeing. They might give you a feeling of belonging or a feeling of being accepted by another person. They might be a way for you to enjoy closeness with yourself or with someone else.
Sexuality and intimacy aren't just about having sexual intercourse (often called sex). Sexuality can mean the way you express yourself – including how you give and receive sexual pleasure, and the things you do to feel close to other people.
Intimacy might mean being emotionally close to another person, and communicating with someone in a way you wouldn't with other people. Physical intimacy might include kissing, holding hands, hugging, touching your body or someone else's.
Sex and intimacy have lots of benefits. They can:
- be a way of communicating your feelings
- make you feel reassured
- bring feelings of tenderness and closeness to others
- make you feel better about yourself
- provide a distraction and a relief from your illness
- reduce stress, anxiety and depression.
Sexuality, intimacy and terminal illness
Being diagnosed with a terminal illness can affect how you feel about your sense of self and your body image. It can also impact your relationships, and how you feel about being close to another person.
For many people, intimate relationships and sex are important aspects of their life. Sex and intimacy can make you feel more connected – both to yourself and other people. And they can help you to find meaning and purpose in life.
Your illness may affect the way you feel about sex and intimacy. It can affect your relationships with other people, like a partner, if you have one. Your illness might also affect how you feel about yourself.
You might find your illness makes you want sex and intimacy more or less often. And as your illness progresses, the way you feel about sex and intimacy might continue to change.
The people you're intimate with
If you have a partner, or more than one person you're intimate with, the way they feel about sex and intimacy might change too. They might want to have sex less often. Or, they might want to try different ways of being intimate.
You might find it harder to talk about sex with them. But if you can, talking about how you're feeling, and how they're feeling, can help. It may help you to better understand what the other wants, and find ways to make sure you both feel fulfilled and close to each other.
Your illness might affect how you feel about starting a new relationship. Your illness or treatments might put you off starting a new relationship. Or you may feel like a new relationship would bring you comfort.
Things that change the way you feel about sex and intimacy
When you're ill, lots of things can affect how you feel about sex, your body, and being intimate. These might include physical things like:
- being in an environment with lots of interruptions, like having carers coming into your home often, or staying in a hospice
- breathlessness (dyspnoea)
- extreme tiredness (fatigue)
- loss of control over your bladder or bowels (incontinence)
- medical equipment, like syringe drivers or colostomy bags
- mouth problems, like a dry or sore mouth
- nausea and vomiting
- pain
- side effects of treatment, like vaginal dryness or difficulty in getting an erection
- weight changes
- low sex drive
- finding it difficult to orgasm
- painful sex or difficulty having penetrative sex
- finding it difficult to get or keep an erection
- problems with ejaculating.
The way you feel emotionally and mentally might affect how you feel about sex and intimacy, too:
- Feeling depressed and anxious can stop you wanting to be intimate. Read more about depression and anxiety.
- You may feel self-conscious about changes to your body from surgery or treatments.
- You may find it hard to think about sex and intimacy if you're living with uncertainty or worried about the future.
- Your illness might affect how you feel about how you express your sexuality – for example, if your body has gone through major changes because of your illness.
- Your illness or treatments might put you off starting a new relationship.
Talking to healthcare professionals
Palliative care involves looking after all aspects of your wellbeing – this includes sex and intimacy. You may have questions for your healthcare professionals, or you may want their advice. Don't feel embarrassed to bring it up with them. You might want to know:
- how your illness, treatment and symptoms will affect your sex life
- ways you can make it easier to have sex (for example, if symptoms like pain and fatigue make it harder, or if your illness is affecting your ability to have sex)
- things you could do to make you feel more confident about yourself and about being intimate
- how you can talk to anyone you're intimate with about how you're feeling
- if you are trans or non-binary, how your illness or treatments might affect hormone therapy or medical transitioning.
When it comes to discussing sex or relationships, your doctor or healthcare team might not always start these conversations with you. However, they can put you in touch with the right person to help you. If you want to speak to them, don't be afraid of starting the conversation yourself.
If you want to speak to a psychologist or counsellor, ask the doctor or healthcare team looking after you. They may refer you to someone who has expertise in working through sexuality or relationship issues. You may also be able to find free counselling services on the NHS.
Find free counselling services near you.
If you're experiencing problems with having sex, you might want to speak to a sex therapist. They are trained to help people manage sexual problems. They can usually meet people as individuals or together with the people they're intimate with.
You might not want to talk to your healthcare professionals about it, and that's OK too. If you have a partner, or people you are intimate with, you could try talking about how you feel with them. Or, you could speak to someone you're not intimate with.
If you're worried about talking
You may worry about talking about sex, intimacy or relationships with healthcare professionals.
For example, sometimes other people may make assumptions about your sexual orientation or gender identity, which could make the conversation more difficult for you. Telling people about your sexual orientation depends on what you're comfortable with and it's different for everyone.
You should always receive high quality care, regardless of your sexual orientation or gender identity. Find out what to do if you're not happy with your care.
Need to talk?
Need to talk? We're here to listen. Our nurses, trained officers and volunteers are here to support you.
• Call our free Support Line on 0800 090 2309
• Chat to us on webchat
• Send us an email at support@mariecurie.org.uk
• Speak with other people in similar situations on our online community
Our Support Line is open 8am – 6pm Monday to Friday and 11am – 5pm on Saturday.
Things to help with sex and intimacy
Below are some things you could try if your sex and intimacy needs have changed.
Asking for privacy
Not having privacy can be a barrier to having sex and intimacy. Think about what you might be able to change to get some extra privacy. This might include having a private room, larger bed, or setting aside private time with no interruptions from healthcare staff or carers. Tell the people involved in your care what you need.
Managing symptoms
If you're experiencing symptoms from your illness or treatment which stop you or make it harder to be intimate, speak to your doctor.
If you're experiencing certain symptoms, there are things you can do to make sex and intimacy easier. If you're having sex with someone else, they might find it helpful to read this list too:
- Breathlessness – take extra pillows and covers off the bed to make it feel more open, and avoid positions which could restrict your breathing.
- Fatigue – take a nap before, plan sex for when you know you'll have more energy, or try different positions which could help you to conserve energy.
- Losing control over your bladder or bowels – use the bath or shower for foreplay, or put towels down to cover an incontinence sheet, if you use one.
- Nausea and vomiting – avoid using strong-smelling perfume or deodorant.
- Pain – take painkillers a short while before having sex, and find positions which are comfortable and reduce the strain on your body.
Finding new ways to connect
Intimacy can be achieved in lots of ways towards the end of life. If you're not able to do the things you enjoyed before, there are other options for feeling close to someone:
- Sexual intercourse – there's more information below on how to do this safely and comfortably.
- Having sex in different ways.
- Touch without sex – for example cuddling, holding hands, or lying close to someone.
- Emotional intimacy – for example expressing your feelings, or talking about things important to you.
- Doing things you enjoy together – for example, watching a favourite film or sharing a meal.
Feeling more confident in your appearance
Some people lose confidence in their appearance when they're ill, but not everyone will. If you are struggling with your confidence or body image, there are organisations which can help:
- Boots Macmillan Beauty Advisors - can help you with managing the visible side effects of cancer treatment.
- Changing Faces - a charity which supports people with a mark, scar or condition that changes their appearance, and offers a helpline, self-help resources and information.
- Look Good, Feel Better - workshops and advice to help women with cancer feel more confident about how they look.
- Macmillan Cancer Support - information about coping with changes to your appearance and body image.
Lubricants
Lubricants can make sex easier and more enjoyable. They can also help to reduce irritation around your genitals.
They normally come as liquids or gels, and they can be water-based, silicon-based, or oil-based. If you're having oxygen therapy, avoid using oil-based products.
You can buy lubricants from a pharmacy. You can speak to your doctor or nurse to find out more about them and which one would be safest for you.
Equipment to make sex easier
If you are disabled, or experience symptoms like pain or fatigue, you might find equipment can make sex easier and more comfortable:
- Using sex aids, like vibrators, can be helpful if you don't have much energy. They can also help to relax muscles.
- Use cushions or pillows to support you or reduce strain on your body.
- Furniture like reclining chairs or adjustable beds can help you to get into more comfortable positions.
Having safe sex
If you're worried about contraception, practising safe sex or pregnancy, speak to your GP for advice.
If you're having chemotherapy, some waste products can get into your blood or bodily fluids. Your doctor might recommend you use a condom during sex or a dental dam (a piece of latex which covers the genitals) for oral sex in the few days after you've had chemotherapy. Condoms and dental dams can also protect against sexually transmitted infections (STIs).
If you're having internal radiotherapy, your doctor will recommend you avoid close contact with other people while the treatment takes place.
External websites
Look Good, Feel Better - offers information and support to help women with cancer feel more confident about how they look
Macmillan Cancer Support – information about sexuality and relationships
Mindout – a mental health service for LBGTQ+ people
NHS – information about sex therapy
Relate – offers relationship support for individuals and couples
Relationships Scotland – offers relationship counselling and other family support services in Scotland
The Sexual Advice Association – sexual health information
Sexual Health NI – information on sexual health and advice in Northern Ireland
Stonewall – information and support for LGBTQ+ people
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About this information
This information is not intended to replace any advice from health or social care professionals. We suggest that you consult with a qualified professional about your individual circumstances. Read more about how our information is created and how it's used.
