How treatment for womb cancer may affect your sex life and fertility

Menopausal symptoms Back to top

If you’ve had a hysterectomy| and your ovaries have also been removed, or if you’ve had radiotherapy to the pelvis, you will have menopausal symptoms (if you have not yet had the menopause). These can include:

• hot flushes
• dry skin
• dryness of the vagina
• feeling low and anxious
• being less interested in sex for a time.

Your doctor or specialist nurse can give you advice and suggest ways of managing many of these problems. If the symptoms are very severe you may want to talk to your doctor about hormone replacement therapy (HRT). Some doctors don’t like to prescribe HRT following womb cancer due to a theoretical risk that the hormones could cause the cancer to come back. But no studies so far have shown this to be the case. As an alternative there are non-hormonal medicines and complementary therapies which can be helpful.

If dryness of the vagina is a problem, your GP or specialist can prescribe lubricating gels, such as K-Y Jelly® or Replens®, or you can buy them yourself from the chemist. You, or your partner, can apply the gels directly to the penis or vagina before or during sex. Occasionally some women are prescribed oestrogen creams.

Narrowing of the vagina Back to top

Radiotherapy| to the pelvis can make the vagina become narrower and this can make sex difficult or uncomfortable.

The key to overcoming this problem is to keep the muscles in the vagina as supple as possible. Hormone creams (available on prescription from your doctor) applied to your vagina can help, but regular sex, or use of a vaginal dilator or vibrator, is often the easiest and most effective treatment.

Sex after treatment Back to top

Many women feel nervous about having sex soon after treatment for cancer, but it’s perfectly safe. Sex won’t make cancer worse and your partner can’t catch cancer from you. Women often find they need to take more time over sex to help the vagina relax. It may also be easier if your partner is very gentle at first, so that your vagina can stretch slowly. Regular, gentle sex will help the vagina to become supple again and you should be able to go back to your usual sex life a few weeks after radiotherapy.

If sex is difficult, you and your partner might find it helps to discuss things with one of your treatment team. Although it might feel embarrassing at first, it can really help to talk things through. Your nurse or doctor will have experience in this area and can advise you about what might help. You can also talk to our cancer support specialists|.

Vaginal dilators Back to top

Your nurse or doctor can give you a set of dilators, which usually come in different sizes. They are usually made of plastic. Some women prefer to use a vibrator, or a combination of both. The dilator or vibrator needs to be gently and regularly inserted into the vagina to stretch it gradually and prevent narrowing. The nurses or your doctor can explain how to do this and answer any questions. They are used to discussing these issues, so you don’t need to feel embarrassed.

Many women find that a dilator or a vibrator (or both) can be very useful to improve the suppleness of the vagina after radiotherapy. They can be helpful for women who may have temporarily lost interest in sex due to menopausal symptoms, who feel nervous about having sex soon after treatment, or who don’t have a regular sexual partner.

Fertility Back to top

Surgery and radiotherapy for womb cancer will prevent you from being able to have children in the future. Younger women, and those who were hoping to have children or add to their family, may be especially upset if they have needed a hysterectomy, or had radiotherapy that has damaged their ovaries.

Women who’ve had their menopause may also feel a deep sense of loss after an operation for womb cancer. Some women feel that the removal of their womb takes away part of their womanhood and they feel less feminine. It can help if you allow yourself time to grieve for children you might have had, or to mourn, as the loss of the womb can give many women a feeling of bereavement.

You may find it helpful to talk to a specialist gynaecological oncology nurse, or a counsellor, who is specially trained to listen and offer support. Our cancer support specialists| can also offer you help at this time.