Managing Sexual Symptoms of Chronic GVHD: Tips and Solutions
Health ConditionsAutoimmune Diseases

How GVHD Can Affect Your Sex Life

How GVHD Can Affect Your Sex Life
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Published on February 26, 2026
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If chronic graft-versus-host disease (GVHD) has put a damper on your sex life, you’re not alone. Physical symptoms like skin rashes, dryness, and tightening, along with fatigue and guilt over lack of intimacy, can impact your sexual health. Plus, hormonal triggers from your previous bone marrow transplant, including early menopause, can create even more challenges. As many as 80 percent of women and 46 percent of men will develop sexual symptoms from a stem cell (bone marrow) transplant, and those numbers may be higher when factoring in chronic GVHD.

The physical symptoms of chronic GVHD generally arise from the chronic systemic inflammation that comes with inheriting the donor’s immune system, hormonal upheaval from forced early menopause, and potentially medication side effects.

 “When you go through transplant, we force early menopause, for example, and usually patients are not able to recover their menstrual cycles,” says Doris Ponce, MD, bone marrow transplant specialist at Memorial Sloan-Kettering Cancer Center, New York City. “And you’re on a lot of medications after transplants, like immunosuppressants, antifungals, antivirals, and other treatments that you need. These can make you feel tired, give you headaches, create GI symptoms, make you feel dry.” And for men, issues such as tightening of skin in the groin and penis area can lead to sexual problems.

But the sexual side effects of chronic GVHD aren’t only physical. You also may experience fatigue, lack of interest, fear, and guilt, among other emotions. A lot of people may feel like they are the reason why their marriage is lacking intimacy, or that they can’t be the partner that they were before GVHD, says Elizabeth Muenks, PhD, clinical director of psychology services for the Hematologic Malignancies and Cellular Therapeutics Blood and Marrow Transplant and Cellular Therapies Program at KU Cancer Center at the University of Kansas in Kansas City. “That is a heavy emotional load to carry,” she says.

Common Sexual Health Problems in Chronic GVHD

Some of the most common sexual symptoms caused by chronic GVHD are:

  • Skin changes around the vulva or on the penis caused by cutaneous (skin) chronic GVHD, such as lesions on the penis.

  • Vaginal dryness, burning, itching caused by hormonal upheaval or transplant medications.
  • Penile skin tightening, pain, erectile dysfunction, reduced sensation in men due to cutaneous chronic GVHD.
  • Dryness and mucosal changes such as dry mouth, eyes, and skin due to chronic GVHD effects on the mucous membranes.
  • Skin rashes or hair thinning/loss anywhere on the body due to cutaneous chronic GVHD that affects body image.

  • Lack of energy to engage in sexual activity due to a combination of physical and emotional issues, such as medication side effects that cause fatigue, pain, or muscle stiffness.
  • Loss of desire due to depression and anxiety caused by a chronic GVHD diagnosis and treatment.

How to Manage Sexual Health Symptoms Caused by Chronic GVHD

Taking control of your sexual health is a great first step to regaining a sense of comfort, fulfillment, and intimacy in your sexual life while managing chronic GVHD.

“The No. 1 thing I recommend is for patients to be their own advocates in speaking up about what’s happening,” Dr. Muenks says. “I don’t always find that sex or sexual health or intimacy is something that comes up at doctor visits.”

For relief from sexual health symptoms caused by chronic GVHD, try to:

  • Enlist your partner or trusted friend to attend appointments with you. If you feel unable to advocate for yourself, they can bring up symptoms on your behalf.
  • Find a psychologist, certified sex therapist, or other counselor with experience in GVHD or transplantation to get the emotional support you need to navigate these issues. A qualified therapist can guide you through fear of infection exposure, partner communication, and intimacy challenges. And take advantage of resources such as BMT InfoNet and the American Association of Sexuality Educators, Counselors and Therapists.
  • Use fragrance-free, over-the-counter water-based lubricants and moisturizers to relieve pain during intercourse if you are experiencing vaginal dryness.

  • Ask your gynecologist or urologist about hormone replacement therapy to regulate hormonal balance and increase your comfort and performance during sex.

  • Request vaginal dilators or pelvic floor therapy from your gynecologist if you experience narrowing of the vagina or leakage due to chronic GVHD.

  • Ask about emerging or off-label treatments you may not realize are available. “There are some off-label treatments that are coming, but they’re not standard care, such as light therapy for skin. [If treatment involves skin in the genital region], that’s something that should be under the discretion of a gynecologist,” Dr. Ponce says.
  • Try journaling. “I’ve found that people who journal about what feels good to them, what times of day are good for them, their energy levels, and starting to track things about their bodies can help them figure out what they can communicate to their partners,” Muenks says.
  • Redefine intimacy by thinking of it as a continuum of closeness, touch, and emotional connection rather than the single act of intercourse with a goal of orgasm.
  • Request that your medical providers exchange notes. For example, have your gynecologist communicate your symptomatology and treatment plan to your transplant doctor. “If the symptoms are severe, and you actually need systemic treatment, you would require a BMT [blood and marrow transplant] doctor,” says Ponce.
  • Stay hopeful for new approaches and new treatments for the sexual side effects of chronic GVHD.

While sex and intimacy issues related to chronic GVHD may pose significant challenges, remember that there are things you can do to address them. “I’m seeing a lot more research being done, and a lot more medications coming out to better treat GVHD,” Muenks says. “There are ways to find a life that has quality and meaning and purpose.”

The Takeaway

  • Graft-versus-host disease can cause physical and emotional side effects that impact your sex life.
  • It’s crucial to self-advocate by reporting genital changes or sexual symptoms to a trusted provider as soon as possible.
  • Medical treatments, journaling, and rethinking intimacy as a continuum all can help to restore intimacy with your partner.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Martínez C. Allogeneic Stem Cell Transplantation and Sexual Disorders. Medical Disorders and Sexual Health. August 2, 2024.
  2. Foregeard N et al. Sexuality- and Fertility-Related Issues in Women After Allogeneic Hematopoietic Stem Cell Transplantation. Transplantation and Cellular Therapy. May 2021.
  3. Chronic Graft-Versus-Host Disease (GVHD) Symptoms and Treatment. BMT Infonet.
  4. Shi CR et al. Cutaneous Chronic Graft-Versus-Host Disease: Clinical Manifestations, Diagnosis, Management, and Supportive Care. Transplantation and Cellular Therapy. September 2024.
  5. Centraccio JA et al. “They Knew the Same Struggles”: Perceptions of a Group Coping Skills Intervention in Patients With Chronic Graft-Versus-Host Disease. Support Care Cancer. January 16, 2025.
  6. Genitals and Chronic GVHD. BMT Infonet.
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Tingting Tan, MD, PhD

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Tingting Tan, MD, PhD, is a medical oncologist at City of Hope National Medical Center.

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