Does chemotherapy cause erectile dysfunction?

Usually not directly. According to the National Cancer Institute, chemotherapy may lower testosterone levels and sex drive (libido) during the treatment period, but it does not usually affect the ability to have an erection.

Erectile dysfunction — trouble getting or keeping an erection — is more often linked with other treatments. Radiation to the pelvis can damage blood vessels or nerves involved in erections. Hormone therapy can lower testosterone and make erections harder to get or keep. Surgery for pelvic cancers can affect the nerves involved, though nerve-sparing surgery can sometimes help prevent this. Some medicines used for pain or depression can also lower sex drive.

One thing to know about chemotherapy is that a condom may be advised, because semen can contain traces of chemotherapy for a period of time after treatment.

If you have concerns about erections or sex drive, the National Cancer Institute notes that once a problem is diagnosed, an oncologist or urologist can advise on options, such as medicines that increase blood flow to the penis or, in some cases, a penile implant. Your care team can explain what is likely with your specific treatment and what may help.