Men and Women
In the United States, the risk of developing colorectal cancer is almost the same for both men and women, but there are some differences in its presence between men and women.
Several studies have revealed that women develop colorectal cancer at an older age than do men, and that their cancers are more likely to develop higher up in the colon, especially as they get older. Men tend to develop cancer farther down the colon and in the rectum.
These differences have important implications for screening. One study estimated that if women over 50 were investigated with a flexible sigmoidoscopy alone rather than with colonoscopy, 44–65% of advanced cancers located higher in the colon would be missed. This is of special concern since some studies suggest that women may be less likely to have a colonoscopy.
There is evidence that estrogen may have a protective effect against the development of colorectal cancer. The Women's Health Initiative (WHI) conducted a randomized controlled study that revealed a 44% reduction in the incidence of colorectal cancer among post menopausal women who had used hormone replacement therapy (HRT). However, HRT-users who developed colorectal cancer had a greater proportion of advanced stage cancer.
Three studies reported being female as a risk for complications of colorectal cancer requiring emergency surgery, such as perforation and bowel obstruction.
Sexual activity can be more difficult to participate in or enjoy when you aren’t feeling well. Physical changes caused by cancer treatments as well as emotional factors such as fear, anxiety and depression can create barriers to intimacy and cause sexual dysfunction in both men and women. Talk to your doctor about your concerns. Knowing how your treatments may affect your sexuality can help you find a solution if problems do occur.
The most common sexual side effect for men is erectile dysfunction. Other side effects may include:
- Loss of interest in sex
- Less energy for sexual activity
- Pain during sex
- Difficulty climaxing or less satisfying orgasms
Sexual side effects are more common in older men, but it’s important to note that some men experience no sexual side effects at all.
Women can experience many of the same sexual side effects from cancer and treatment as men do including loss of desire for sex, less energy, and difficulty reaching climax. Additionally, women may experience pain during penetration and vaginal dryness, or may have no sexual side effects at all.
Women of childbearing age should talk with doctors about the possible impact of cancer treatments on their ability to conceive and options for preserving fertility. Surgery and standard chemotherapy may or may not have an effect on female fertility. However, adjuvant chemotherapy using oxaliplatin may be more harmful, and adjuvant and neoadjuvant radiation therapy may cause premature ovarian failure.