Valentine’s Day: Sex, intimacy and relationships at the end of life
When someone is living with a terminal illness, nearly every part of life can shift, including how they feel about their body, their sexuality, and their relationships.
Studies have shown that many patients nearing the end of their lives have expressed that sex and intimacy are essential to them; however, it is often overlooked by healthcare professionals and not commonly discussed. But the need for closeness, connection and intimacy doesn’t just disappear because of illness. In fact, understanding and facilitating these needs can be an important part of someone’s emotional wellbeing.
Sex and intimacy can:
help people communicate feelings that are hard to put into words
boost confidence and reduce stress or anxiety
provide comfort or a welcome distraction from illness challenges
How illness can change things
A terminal diagnosis can affect body image, energy, emotions, and relationships. People might find that their interest in or ability to express sexuality changes over time. Some people want more intimacy; others less. What matters is understanding those feelings and adapting to them.
A partner’s feelings may also shift. Illness can change how someone wants to be intimate or how they view physical closeness. It can change their perception of their partner as someone who is too unwell for intimacy or they may assume it is not a priority.
What can affect intimacy?
Illness and its treatment can impact sexual health in many ways, both physically and emotionally. Things that might make intimacy harder include:
fatigue, pain, breathlessness or other symptoms
medical equipment like infusion pumps or stomas
changes in body image or confidence
side effects like reduced libido, vaginal dryness or erectile difficulties
emotional stress, anxiety or depression.
These changes aren’t just physical. Feeling worried about the future or self-conscious about how their body looks or works can also affect desire for closeness.
Support from a healthcare team
Sexuality and intimacy don’t always come up automatically or can be difficult to talk about. Patients should ask their doctor, nurse or palliative care team questions like:
How might my illness or treatment affect my sex life?
What can we do to make intimacy more comfortable?
How can I talk to my partner about what I’m feeling?
Healthcare teams may also be able to connect patients with counsellors or therapists experienced in supporting sexual or relationship concerns.
Ways to Support Intimacy
Here are some practical ideas that may be helpful:
Create privacy: Request carers or healthcare staff to give the couple uninterrupted time together.
Manage symptoms: Work with the medical team to ease pain, breathlessness or fatigue so intimacy feels more comfortable. Simple adjustments like using pillows for support or planning intimate moments at times they have more energy can make a big difference.
Try different ways to connect: Intimacy isn’t only about sex. Cuddling, holding hands, watching a favourite film together, or simply being present with each other can all deepen closeness.
Use supportive tools: Lubricants can help with dryness; pillows and adjustable furniture can make positions more comfortable; sex aids might help reduce effort.
Stay safe: If there are concerns about contraception, safe sex or sexually transmitted infections, talking with a GP is very important, especially if the patient is undergoing treatments like chemotherapy.
Dying for Sex – TV tackling the taboo
While sex and intimacy at the end of life is not yet commonly discussed, TV show ‘Dying for Sex’ steers directly into the topic, looking at it through a lens of both humour and startling insight. You can read our full review of Dying for Sex here.
The importance of intimacy at the end of life
If you or someone you care about is facing these kinds of challenges, remember: intimacy and connection matter, it’s normal, and it’s important to talk about them with healthcare staff who can support finding ways to ensure intimacy needs are met.