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For many people with cancer, a bone marrow transplant (also called a stem cell transplant) is a lifesaver. But as with other cancer treatments, there are side effects to this complex procedure.

Your doctor will talk to you about the side effects of a bone marrow transplant. One topic they should cover is how the procedure may affect your sexual health. (If your doctor doesn’t bring the subject up, you should.)

Here’s what to expect after a bone marrow transplant when it comes to your hormones and sexual health.

Bone Marrow Basics

Bone marrow is soft tissue in the center of your bones. It contains blood-forming stem cells, which grow into white blood cells, red blood cells, and platelets.

Both cancer and cancer treatments can damage stem cells.

A bone marrow transplant is a medical treatment for certain types of cancer. Doctors use it for leukemia, myeloma, lymphoma, and other blood and immune system diseases that affect your bone marrow. Before the transplant, you’ll receive chemotherapy and/or radiation therapy.

In a bone marrow transplant, doctors infuse healthy stem cells into your blood, which will find their way to your bone marrow. The healthy stem cells restore your body’s ability to make red blood cells, white blood cells, and platelets.

What to Expect After Bone Marrow Transplant

When you’re recovering from a bone marrow transplant, you need to avoid getting any infections. It may take an entire year for your immune system to recover from the transplant.

In the weeks and months following surgery, you may find that your sexual health isn’t the first thing on your mind. However, it’s important to talk to your doctor about your long-term recovery and how the transplant will affect you sexually.

Chemotherapy and radiation before a bone marrow transplant can reduce your testosterone levels. Testosterone is the main sex hormone in men. Lower levels of testosterone may cause reduced sexual desire and other sexual health problems.

After a transplant, you also may experience pain, fatigue, and changes to your self-esteem that affect your feelings of confidence. These changes are common, and they affect your sexual health. According to the Blood and Marrow Transplant Information Network, nearly half of all men report lower sexual activity five years after a transplant.

Sexual Health and Side Effects of Bone Marrow Transplant

One major side effect of a bone marrow transplant is male infertility. Chemotherapy, radiation, and transplant drugs can damage reproductive organs and cause infertility in men.

Sometimes fertility returns, but it’s unpredictable. If you’re interested in becoming a father later, you may want to consider banking sperm before a transplant.

You may also experience one or more of the following side effects of bone marrow transplant.

• Loss of interest in sex.
• Erectile dysfunction (ED).
• Problems with ejaculation and orgasm.
• Depression.
• Low self-esteem.
• An increased concern about your physical appearance.
• Changes in your body.
• Pain during sex.
• Worries about germs and infection during sex.
• Graft-versus-host disease of the penis.

Your Sexual Health Recovery

Some of the changes you’ll experience with a bone marrow transplant are temporary. For instance, most men recover testosterone levels within two years following surgery. They gain strength and energy as they recover.

But if you were already having sexual health problems (like ED) before your cancer, they may get worse after the transplant.

However, there are treatments and therapies to help you regain your sexual function. Depending on your exact symptoms and overall health, your doctor may recommend:

• Testosterone replacement therapy.
• Counseling for you and your partner.
• Prescription medicine to increase blood flow to the penis.
• Injection therapy for ED to increase blood flow to the penis.
• A vacuum erection device.
• Penile implants.

Your sexual health is important to your overall well-being, and having a bone marrow transplant doesn’t mean an end to your sexuality. Have an honest conversation with your doctor about any concerns you have about your sexual health after your transplant.