Sex, fertility and Hodgkin's lymphoma

• A quick guide to what's on this page
• Your sex life and Hodgkin’s lymphoma
• Treatment and your risk of becoming infertile
• Early menopause
• Coping with infertility

Unless you have a very low platelet count, there is no physical reason why having Hodgkin's lymphoma or being treated should affect your sex life. But you will probably go through times when you do not feel like sex because you are too tired or have treatment side effects. If you have a very low platelet count intercourse may not be recommended because of the risk of bleeding. Discuss this with your doctor or nurse if you are not sure.

If you are a man having chemotherapy, you should wear a condom. This is because semen can cause a stinging sensation in the woman's vagina if her partner is having chemotherapy. This means some of the drug may be coming through and doctors don't know enough about whether this could be harmful.

If you are a woman having chemotherapy, you should make sure you use contraception to stop you getting pregnant. The drugs could damage the developing baby. Even if your periods have stopped, it may be possible to get pregnant so you should take precautions.

If you would like more information about anything to do with coping with sex after treatment, contact one of the cancer information organisations. They will be happy to help. They often have free factsheets and booklets that they can send to you.

Some chemotherapy treatment for Hodgkin's lymphoma can cause infertility. If they can, doctors will use drugs that do not cause infertility instead of those that do. But the first priority is treating your Hodgkin's lymphoma.

If you become infertile you will not be able to have children after your treatment. Having a bone marrow or stem cell transplant will almost certainly mean you will be infertile.

With some chemotherapy treatment, it is not possible for your doctor to be certain whether you will be infertile or not. This will depend on

• The chemotherapy drugs you have
• The total dose of each drug
• Your age if you are a woman

Some drugs are likely to cause infertility but don't always do so. Some people may be made infertile at a lower dose of a particular drug than other people. Some drugs cause temporary infertility. So your fertility may come back six months to a year after your treatment has finished.

Your doctor will tell you whether your chemotherapy is likely to make you infertile and answer your questions before you start your treatment. If you have a partner, you may want to see the doctor together so that you can both ask questions and discuss any fears or worries.

Infertility in men

Even if your treatment will stop you producing sperm, it may be possible for you to have sperm frozen and stored before you start your treatment. This is called sperm banking. Sperm banking means you will be able to have children in the future because the frozen sperm can be used to make your partner pregnant.

Teenage boys can also have sperm frozen. Their sperm can be stored for use in later years.

It is not always possible for men to have sperm stored. Sometimes men who have cancer have fewer sperm in their semen. There may not be enough to be worth storing. But you can have a sample tested to see.

Infertility in women

If you are a woman, the nearer you are to the age when you would naturally have the menopause (or change of life), the more likely it is that chemotherapy will make you infertile. But if your periods stop, or become irregular during your chemotherapy, this does not necessarily mean you will be infertile. Your periods can return to normal six months to a year after treatment has finished.

There is ongoing research into ways to help women who have been treated with chemotherapy to keep their fertility. It is now possible to have eggs frozen, in much the same way that men can freeze sperm. You have to have hormones to stimulate your ovaries to produce eggs and this can take a few weeks, depending on where you are in your menstrual cycle. Another promising research area is to freeze some ovarian tissue and then re-implant it into the body after chemotherapy has finished. This research is still at an early stage.

There is more about the different ways of keeping your fertility in the fertility and chemotherapy section of CancerHelp UK.

If your periods stop permanently after chemotherapy, this is called an early menopause. This can cause other symptoms apart from not having periods. You may have

• Hot flushes and sweats
• Dryness of the vagina
• Less interest in sex
• Dry skin
• Loss of energy
• Mood swings, loss of concentration or just feeling low

Your doctor will probably offer you hormone replacement therapy or HRT. HRT is treatment with hormones you would be producing naturally if you had not had an early menopause. These hormones are called oestrogen and progesterone. HRT can stop all the symptoms of early menopause. It can also help to prevent long term problems like thinning of the bones (osteoporosis) and heart disease.

HRT can be taken in tablet form or given in skin patches that are like plasters. The dose of hormones in hormone replacement therapy is lower than the dose you would normally produce if you had not had an early menopause. So you are very unlikely to have any side effects.

It can be extremely distressing to find that the treatment you need means you will not be able to have children. It can seem very unfair to have to cope with this as well as your cancer. Even for people who had not thought about having children, losing your fertility can be very difficult to come to terms with. It can affect the way you feel about yourself.

You will not be able to come to terms with this quickly. It will take time. Give yourself time to adjust and feel sad. Talking to someone close will almost certainly help. But you may not be able to do this for a while.

You may want to talk to someone other than your partner, family or friends. Some people find it helpful to talk to a therapist or counsellor. Ask your doctor if you can be put in touch with some professional help if you think it would be helpful for you.

If you would like to talk to someone outside your own friends and family, look on our counselling organisations page. To find out more about counselling, look in what is counselling?.