Sexuality, intimacy and relationships

When you're living with a terminal illness, the way you feel about sexuality, intimacy and body image may change. Here, we talk about how your feelings towards sex and intimacy may change, and the support you could get if they do.

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 are not 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:

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.

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 both 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.

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:

The way you feel emotionally and mentally might affect how you feel about sex and intimacy, too:

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. Try not to feel embarrassed to bring it up with them. You might want to know:

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.

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.

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. If you’re unhappy with your care, you may want to talk to someone or raise a complaint.

Below are some things you could try if your sex and intimacy needs have changed.

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.

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:

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:

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.

If you are disabled, or experience symptoms like pain or fatigue, you might find equipment can make sex easier and more comfortable:

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.

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: