# Sexual function, fertility and body image after bowel cancer

Source: https://onco.cc/terms/sex-fertility-after-bowel-cancer/  
OnCo record `sex-fertility-after-bowel-cancer` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Pelvic surgery and radiotherapy can affect the nerves and tissues that control erections, ejaculation, vaginal comfort and sensation, and pelvic radiotherapy often causes infertility and an early menopause. NICE asks teams to raise altered sexual function before treatment, and a fertility referral belongs before treatment starts, not after.

## Summary

NICE NG151 (1.2.1, 1.2.4 and 1.2.6) asks teams to give information on the possible effects of treatment on bowel and sexual function before a decision is made, to have appropriate specialists discuss altered bowel, urinary and sexual function after surgery, and to give information about short-term, long-term, permanent and late side effects including altered sexual function and changes to self-perception and social identity. Bowel Cancer UK says cancer and its treatment may affect body image, emotions and relationships, and that side effects may also affect the ability to have sex; it suggests talking to someone close or to the specialist nurse, and says a stoma care nurse specialist can help with the sudden change to the body, that a stoma should not stop you doing what you enjoy, and that underwear and swimwear made for people with stomas can help. On fertility it says some treatments for bowel cancer affect fertility in men and women and the team should discuss this at diagnosis; that radiotherapy to the pelvis will often cause infertility and an early menopause and will affect the uterus so that a successful pregnancy is not possible even with fertility treatment, with surrogacy among the options a team will explain; that chemotherapy can cause temporary or permanent infertility depending on the drugs and doses, with periods sometimes returning six months to a year later and sometimes not; that having periods does not by itself mean pregnancy is possible; and that both men and women should use contraception during radiotherapy and chemotherapy and for about a year after treatment ends. The NHS says a colostomy will not affect fertility but to check with the doctor that you are fully recovered before trying to get pregnant, that you can continue your sex life as before once you feel ready, that trying different positions may help if there is discomfort, and to talk to the stoma nurse about sex, relationships or body image.

## Fields

- Kind: Term
- Last checked: 2026-09-24
- Also known as: erectile difficulties after rectal surgery; vaginal dryness after pelvic radiotherapy; body image with a stoma; fertility after bowel cancer
- Tags: gi; colorectal

## Sources

- NICE NG151: colorectal cancer, recommendations: https://www.nice.org.uk/guidance/ng151/chapter/Recommendations
- Bowel Cancer UK: body image and sex: https://www.bowelcanceruk.org.uk/about-bowel-cancer/living-with-and-beyond-bowel-cancer/body-image-and-sex/
- Bowel Cancer UK: fertility: https://www.bowelcanceruk.org.uk/about-bowel-cancer/living-with-and-beyond-bowel-cancer/fertility/
- Cancer Research UK: your sex life and bowel cancer: https://www.cancerresearchuk.org/about-cancer/bowel-cancer/living-with/sex-life
- Macmillan: sex life after bowel cancer: https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/sex-life-and-bowel-cancer
- Macmillan: fertility and cancer: https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/fertility
- NHS: recovery and lifestyle changes after a colostomy: https://www.nhs.uk/tests-and-treatments/colostomy/recovery-and-lifestyle-changes-after-a-colostomy/
- Colostomy UK: love, sex and relationships: https://www.colostomyuk.org/information/love-and-relationships/

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/)
- technologies: [Oncofertility and fertility preservation](https://onco.cc/technologies/fertility-preservation/), [Psycho-oncology and distress screening](https://onco.cc/technologies/psycho-oncology/)
- terms: [Late effects and survivorship toxicity](https://onco.cc/terms/late-effects/), [Stoma (colostomy, ileostomy, urostomy)](https://onco.cc/terms/stoma/)

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