Some possible physical effects on women
It can help to know a bit about the female sex organs and how the possible effects of cancer and its treatment might affect your sex life.
In girls and women the pelvic area includes the sexual organs: the ovaries, fallopian tubes, the womb and the vagina. The bladder and the lower part of the bowel are also close by.
Some cancer treatments can cause vaginal dryness. This may be due to low levels of the female hormone oestrogen. Radiotherapy to the pelvic area may stop the ovaries producing oestrogen. Sometimes the ovaries need to be removed as part of treatment for cancer, and this causes lower oestrogen levels. If you have both your ovaries removed, you will then have an early menopause (also called a premature menopause). This is when your periods stop permanently.
An early menopause can also be caused by treatment that affects the gland in the brain called the pituitary gland. The pituitary gland produces hormones that control the production of oestrogen by the ovaries.
If you’ve had surgery to your vagina that’s made it narrower or shorter, this can make sex uncomfortable. This is very rare, though. Damage to the nerves from pelvic surgery or pelvic radiotherapy can reduce your ability to feel pleasure during sex, or mean that you take longer to orgasm (‘come’). These changes may be due to a difference in the way you feel about yourself sexually. A sex therapist or counsellor can give you advice about this.
What can help?
If you have a dry vagina, this can be treated by using a cream or gel on the inside lining of your vagina. These can be bought from a pharmacist or prescribed by your GP. You can ask for products such as Senselle®, Astroglide® or SYLK®.
Radiotherapy to the pelvis can make the vagina become narrower, and this can make internal examinations and penetrative sex uncomfortable. Your hospital team will usually recommend that you use vaginal dilators to try to prevent the vagina from narrowing. Dilators are tampon-shaped plastic tubes of different sizes that you use along with a lubricant.
You may be advised to begin using a vaginal dilator during your radiotherapy treatment or immediately afterwards. Using a dilator regularly may make it easier for your doctors to examine your vagina and cervix after treatment. Having regular penetrative sex or using your or your partner’s lubricated fingers may also help keep the vagina from narrowing. Even if you’re having regular sex, you may still be advised to use a dilator.
Although vaginal dilators 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.
We have more information about the possible effects of pelvic radiotherapy on women, which has been written for women of all ages.