Sexuality following hematopoietic cell transplantation.

Hematopoietic cell transplantation (HCT) is a therapeutic modality used to treat a variety of malignant and nonmalignant disorders. Because HCT often involves the use of high-dose radiation and chemotherapy, it is associated with numerous toxicities and effects, including changes in sexuality and sexual functioning. These changes may include decreased libido, erectile and ejaculatory dysfunction, premature menopause, vaginal alterations, dyspareunia, and infertility. Psychosocial factors, such as anxiety, depression, and concurrent life stressors, also may affect sexuality and sexual functioning. Healthcare providers caring for patients undergoing HCT need to initiate discussions about the impact of HCT on sexuality pretransplant and continue those discussions throughout and following the treatment process.