Sex is a sensitive subject to discuss under the most ordinary of circumstances, but it can become particularly delicate to speak about following bowel cancer.

Low energy levels and physical discomfort after surgery can affect how a person feels about wanting to have sex.

Almost half of all men who have had treatment for bowel cancer find that they have problems associated with interest in sex and with performance, because of their diagnosis and treatment.

Women who have had bowel cancer treatment also report difficulties including anxiety around intimate relationships and sexual intercourse, which, if not addressed early, can undermine recovery and can sometimes lead to problems with personal relationships.

Surgery, some chemotherapy drugs, and radiotherapy can affect the tiny nerve endings and blood vessels around the pelvis, causing local inflammation and swelling, changing the sensations felt.

This is often only a temporary problem that will gradually settle down, but occasionally there may be some longer-term loss of sensitivity or numbness in and around the pelvis and genital area.

Partners are encouraged to have fun making small changes to favourite positions or find other ways of giving each other pleasure, to avoid putting pressure on newly healing wounds or a stoma.

For women who have had radiotherapy, there is an increased risk of vaginal dryness and tightening, as a side-effect of the treatment, which can make penetration and vaginal exams uncomfortable or painful.

This can be eased in several ways, including using intimate lubricating gels or creams to help moisten the vagina, and by gently massaging the area with a finger to keep it supple.

A vaginal dilator may also help prevent tight bands of scar tissue forming and keep the vagina ‘open’ after treatment has finished and while the woman is not sexually active.

For men, surgery or radiotherapy can make achieving or keeping an erection difficult.

Side-effects of treatment are often short-lived and gradually disappear over the course of a few weeks or months, but occasionally they can become something that remains a problem.

There are things that can be done to help those who have concerns about intimate issues or are experiencing long-term difficulties.

For techniques, medications, practical tips and advice that can help with these challenges, or to discuss new ways to achieve satisfaction and intimacy, speak with your GP or specialist.

Health professionals are available to talk through worries or to help find solutions to practical problems or concerns.

A GP or nurse can make the referral.

If you have further questions, contact a Bowel Care Nurse.