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.
The female sex organs
The female sex organs are mostly inside the body, in the pelvic area. They include the ovaries, fallopian tubes, womb and vagina. The bladder and the lower part of the bowel are also close by.
- Some cancer treatments can cause vaginal dryness. This may be because of 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 to treat the cancer. This also causes lower oestrogen levels.
- If both your ovaries are removed, you will have an immediate menopause (also called an early or premature menopause). This stops your periods and causes permanent infertility. An early menopause can also be caused by radiotherapy to both ovaries, or by treatment that affects the pituitary gland (a gland in the brain). The pituitary gland produces hormones that control the production of oestrogen by the ovaries.
- Some surgery to the vagina can make it narrower or shorter, which can make sex uncomfortable. This is very rare, though. If pelvic surgery or pelvic radiotherapy damages the nerves, this can cause scarring to the vagina. This can reduce your ability to feel pleasure during sex, or mean that you take longer to orgasm (come). These changes can also 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?
Using a cream or gel on the inside lining of your vagina can help with dryness. These can be bought from a pharmacist, online or prescribed by your GP. You can ask for products such as Senselle ®, Astroglide ® or Sylk ®.
Radiotherapy to the pelvis can make the vagina narrower, which 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 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 stop the vagina from narrowing. Even if you’re having regular sex, you may still be advised to use a dilator.
We have more information about pelvic radiotherapy which has been written for women of all ages.