How treatment for womb cancer (endometrial cancer) may affect your sex life and fertility
The treatments for womb cancer (endometrial cancer) may affect your sex life, but many of these effects can be prevented or treated.
Treatment for womb cancer may affect your sex life and how you feel about yourself sexually. In this section we explain what can be done to improve these problems. We’ve also included information for younger women who may lose their fertility (ability to have children).
If you haven’t been through the menopause, a hysterectomy that involves removing your ovaries will bring on your menopause straight away.
Women who have radiotherapy without any surgery will also have their menopause. This is because radiotherapy stops the ovaries from working.
Hormone replacement therapy (HRT) isn’t usually advised after womb cancer because it contains oestrogen. But there’s no evidence that it increases the risk of the cancer coming back.
Some cancer specialists may prescribe HRT for women who had early womb cancer and who are having troublesome menopausal symptoms. This may be prescribed when other measures haven’t worked.
Some common symptoms of the menopause include:
Hot flushes and sweats
Low doses of antidepressant drugs can be prescribed to reduce flushes.
Non-hormonal creams and water-based lubricants help reduce discomfort during sex.
Low sex drive
Vaginal changes can reduce your sex drive. However, help to manage these changes can improve things for many women.
These can include mood swings, feeling anxious, and problems with concentration and memory. Talking about your feelings with your family, friends, doctor or nurse can help. Some women find it helps to talk things through with a counsellor.
An early menopause can increase the risk of bone thinning (osteoporosis).
Our section on bone health has helpful tips on keeping your bones healthy.
Your doctor or specialist nurse can give you advice on how to manage symptoms and sometimes drugs can be prescribed to reduce hot flushes.
A number of organisations, including The Daisy Network, provide support to women going through the menopause.
Diane's treatment for breast cancer meant that she went through the menopause early. Watch her story.
Radiotherapy to the pelvis can make the vagina narrower and less stretchy. It also reduces the natural lubrication in the vagina, making it drier. This can make having sex or an internal medical examination uncomfortable, so it’s important to try to keep the vagina from narrowing. Your specialist nurse will explain more about this and answer any questions you may have. They are used to discussing these issues, so you needn’t feel embarrassed.
Your hospital team may recommend you use vaginal dilators to try to prevent the vagina from narrowing. Dilators are tampon-shaped plastic tubes of different sizes that are used with a lubricant. Although they are commonly used, there isn’t strong evidence to say how effective they are. Rarely, they may cause damage to the vagina, especially if they aren’t used correctly. Your specialist nurse or doctor will explain how best to use them in your particular situation.
Having regular penetrative sex, using a dildo, using a vibrator or using lubricated fingers may also help keep the vagina from narrowing. Even if you are having regular sex, you may still be advised to use a dilator.
Different creams, gels, lubricants or pessaries (small pellets that are put inside the vagina) can help with this. Your doctor may recommend using vaginal oestrogen creams or pessaries, which can be prescribed. Although your body absorbs some oestrogen from these products, doctors think it’s too small an amount to be harmful. Your cancer doctor will tell you if it’s advisable for you to take these.
There are lots of products to improve vaginal dryness that you can buy from most chemists and some supermarkets.
For example, Replens MD® cream or water-based lubricants such as Senselle®, Astroglide®, Sylk®, Vielle® or Durex® lube. Vaginal dryness can make you more likely to get infections, such as thrush, so let your doctor know if you have symptoms such as itching or soreness.
Womb cancer, its treatments and their side effects may affect your sex life and how you feel about yourself as a woman. This often gradually improves after treatment, although for some women it may take longer. Try not to think that sex is never going to be important in your life again. There may be a period of adjustment for you and your partner, if you have one.
Cuddles, kisses and massages are affectionate and sensual ways of showing how much you care for someone, even if you don’t feel like having sex. You can wait until you and your partner feel ready - there’s no right or wrong time.
It’s common to feel nervous about sex after cancer treatment, but it’s perfectly safe for both you and your partner. At first it may be easier to take more time to help you relax and for your partner to be very gentle.
Let your doctor or nurse know if you’re having problems with your sex life. They may be able to reassure you and offer help and support. If you feel uncomfortable talking to your doctor or nurse, you can call us. Some people may find it helpful to talk to a sex therapist. You can contact a therapist through The College of Sexual and Relationship Therapists.
Surgery and radiotherapy for womb cancer mean that you won’t be able to have children. Although most women who have womb cancer are older, it does occasionally affect younger women. If your fertility is a concern for you, it’s important to discuss it with your cancer specialist before your treatment starts. Fertility is a very important part of many people’s lives, and not being able to have children can seem especially hard when you already have cancer to cope with.
Occasionally, women may have their eggs removed and stored before having radiotherapy. This may happen if they want to consider trying having a child through surrogacy (when another woman carries a baby for you) in the future.
There’s more detailed information in our section on cancer treatment and fertility in women.