Multiple Myeloma and Your Intimacy

Medically Reviewed by Jennifer Robinson, MD on June 24, 2024
Written by Janie McQueen
4 min read

Multiple myeloma can affect your intimate relationships in a number of ways. Your meds can cause side effects that impact sexual function. Many other factors such as lack of desire, fatigue, body image, and anxiety can come into play, too.

Some reasons for dysfunction relate solely to female or male anatomy. Others, including drug side effects and moods, can affect both women and men in the same way. There’s good news, though. Your health care provider – and perhaps a good therapist – can help you zero in on what you want to improve about your intimate life and help find satisfying solutions.

You might not notice changes in your sex drive or how you feel about your own sexuality at all. Everyone’s different. It’s key to know physical and emotional shifts when you have multiple myeloma (MM) are perfectly normal.

Sexual dysfunction means anything that keeps you from having a fulfilling sex life. Your endocrinologist, urologist, or gynecologist can help get you on the right path for safe and effective medical treatments for it. Meanwhile, therapy can help you and your partner create a new level of intimacy and a satisfying sex life. (It can help if you’re single, too.)

Some drugs can lead to erectile dysfunction, or ED. These include meds for chemotherapy and oral immunomodulatory drugs like thalidomide. For instance, thalidomide has cancer-fighting properties and can ease swelling. But it can also trigger a condition called peripheral neuropathy, which impairs the nerves in your feet, legs, hands, arms – and your penis.

Your emotions can factor in, too. For example, depression can trigger symptoms that lead to ED.

Whatever the cause, ED isn’t hard to treat. Some ways include:

  • Medications called PDE-5 inhibitors (pills you take to help you get an erection)
  • A vacuum erection device, or penis pump
  • A penile prosthesis or implant

Your doctor will be able to help you and your partner explore the options.

About half of women with multiple myeloma report sexual dysfunction. Many things can cause it, including meds and hormone therapy. For example, alkylating agents used for chemotherapy and stem cell transplants may cause ovarian failure. This can cause decreased desire, vaginal dryness, and painful intercourse.

Simple treatments can ease discomfort and boost your libido. They include:

  • Flibanserin (Addyi), an FDA-approved drug developed for premenopausal women who have a low sex drive
  • Bremelanotide (Vyleesi), an injectable drug that can rewire paths in your brain that trigger sexual response. Women have reported more satisfying sex as well as heightened desire and arousal when taking it.
  • Vaginal lubricants to banish dryness

Ask your gynecologist about the best choices.

Many drugs can dampen sexual desire. For instance, corticosteroids, such as dexamethasone, are one of the most commonly prescribed meds to treat MM. They have cancer-fighting properties and can decrease swelling. They also can lower your libido. Your doctor can help find a solution. For example, they might lower your dose or suggest hormone therapy.

Changes in your body image or feeling weak or sick can make you feel less attractive. Some people with multiple myeloma have bladder problems, diarrhea, scarring, problems breathing, and other symptoms that can make you not feel like having sex.

If you’re feeling bad about yourself, or are tired, you also might not have the energy to keep up your personal grooming routine, such as fixing your hair, choosing a nice outfit, or putting on makeup or shaving.

A combo of therapy and physical treatments can help. Sex counseling or sex education can let you and your partner catch up with changes that have happened. Your partner going along also can bring you closer together and boost your body image.

Fatigue not only makes you tired and not want to do anything, it can put a damper on your relationships. Talk to your doctor about ways you can boost your energy. They might:

  • Tweak your meds
  • Prescribe meds that can pep you up during the day
  • Suggest a clinical trial
  • Have you change your diet and amp up your fluid intake

Finding ways to recharge can also boost your intimate life. You also can share some activities with your partner, such as:

  • Trying a new type of exercise
  • Trying massage and aromatherapy
  • Trying yoga
  • Trying mindfulness practices like meditation

Sex isn’t the only way to be intimate. You also don’t have to have intercourse to have a sex life. Your romantic physical life can include:

  • Cuddling or enjoying physical closeness, like holding hands or just sitting close
  • Kissing
  • Massage or stroking
  • Being open to other ways your partner can arouse you
  • Trying sexual aids such as a vibrator, sensual lubes, and more

Your desire for closeness or to be attractive to someone else doesn’t necessarily stop when you have multiple myeloma. Your symptoms, treatment, and physical and emotional changes might make you feel unsure or shy about starting a relationship or being intimate with someone new. Here are a few things to try:

  • A therapist can help you decide what you’re ready for and how to resolve current needs and feelings.
  • Taking care of yourself – eating right, exercising, doing things that make you happy – will lift your self-esteem and brighten your outlook.
  • Don’t rush. Allow yourself time to get secure in your own skin and adjust to your life with MM until you’re ready to share it with someone else.