Possible side effects

During your radiotherapy treatment you may develop side effects. These usually disappear over time. Tell your doctor or nurse about any side effects you have. They can tell you what might help.

  • Your skin in the area being treated may become dry or irritated – wash using lukewarm water and use a soft towel to pat yourself dry
  • you may want to pass urine more often or get pain when you do pass urine – drinking plenty of fluids will help
  • diarrhoea – if this is a problem, your doctor can prescribe medicines to help
  • tiredness – get plenty of rest but doing some gentle physical activity will give you more energy
  • your pubic hair may fall out
  • radiotherapy to the vulva may affect your ovaries and cause early menopause
  • you may notice a narrowing of the vagina.

Effects on your sexuality, such as narrowing of the vagina and an early menopause may be very difficult to cope with. You can talk to your doctor who may refer you to a professional counsellor if you’d find this helpful.

Possible side effects of radiotherapy

You may develop side effects over the course of your treatment. These usually disappear gradually over a few weeks or months after treatment finishes. Your doctor, nurse or radiographer will discuss this with you so you know what to expect. Let them know about any side effects you have during or after treatment, as there are often things that can be done to help.

It's not unusual to feel worse before you start to feel better. Some people can find this a very difficult time and they may feel low or even depressed for a while. The clinical oncologist can advise you about what to expect.

Skin irritation

You may find the skin around your vulva and groin becomes dry and irritated. Your specialist can prescribe cream to help soothe the soreness. Use lukewarm water to wash the area, and gently pat the area dry with a soft towel. You shouldn’t use talcum powder or perfume, as these can cause irritation.

Your radiographer or nurse will advise you on how to look after your skin during treatment.

Bladder changes

Radiotherapy can also irritate the bladder, which makes you want to pass urine more often and causes a burning feeling when you pass urine. Your doctor can prescribe medicines to reduce these symptoms. Drinking plenty of fluids (2 litres/3 pints a day) will also help.

Bowel changes

Radiotherapy to the pelvis may irritate the bowel and cause diarrhoea and soreness around the back passage. Your doctor will prescribe anti-diarrhoea medicine to help control this. Make sure you drink plenty of fluids if you have diarrhoea. Eating a low-fibre diet may help reduce diarrhoea. This means avoiding wholemeal bread and pasta, raw fruit, cereals and vegetables during and for a couple of weeks after treatment.


Many people feel tired when having radiotherapy. Tiredness can continue for weeks or months after your treatment has finished. It can often be made worse by having to travel to hospital each day, or by other treatments such as surgery or chemotherapy. Pace yourself and save your energy for the things you have to do, and that you enjoy. Get plenty of rest but balance this with some physical activity, such as short walks, which will give you more energy.

Hair loss

Radiotherapy for cancer of the vulva can make your pubic hair fall out. It may grow back after treatment, but for some women the hair loss may be permanent.

Early menopause

Radiotherapy to the pelvis affects the ovaries and may cause you to have an early menopause.

Symptoms of the menopause can include:

  • hot flushes and sweats
  • lower sex drive
  • mood swings and poor concentration
  • vaginal dryness
  • hot flushes and sweats.

You may be able to take hormone replacement therapy (HRT) to help with some of the symptoms. There are different ways to manage symptoms if you can’t have HRT or don’t want it. Your doctor will be able to talk to you about HRT and other options for managing symptoms of an early menopause.

If you still have periods and you have an early menopause, you won’t be able to become pregnant. It’s important to talk to your cancer specialist about your fertility before treatment starts.

Becoming infertile can be hard to cope with, whether or not you already have children. Some women find it helpful to talk to a trained counsellor. You can ask your doctor or nurse to arrange this for you.

Narrowing of the vagina

While you’re having radiotherapy, and for a few weeks afterwards, your vagina will be tender. The radiotherapy may cause some scarring, which makes the vagina narrower and less flexible. This may make having sex uncomfortable or difficult. You may be advised to use vaginal dilators with a lubricating jelly, to keep the vaginal walls open and supple. The dilators are usually made of plastic. Your nurse or doctor can give them to you and explain how to use them. You won’t need to use vaginal dilators if you only have radiotherapy to your groin, rather than to your vulval area.

Applying a hormone cream to your vagina may also help. These are available on prescription from your doctor. Regular sex may also help to prevent the vagina from shrinking, but you may not feel ready for sex for some time.


The vulva is very sensitive to radiation. You may get some swelling in the vulva for months or sometimes years after radiotherapy. The swelling can be reduced by gentle, upwards massage, which a specialist nurse or physiotherapist can teach you to do.

Changes to the skin

The skin of the vulva may become permanently discoloured (reddened or darker).

Back to Radiotherapy explained

Before your radiotherapy

Before you start radiotherapy, your team will explain what your treatment involves and how it may affect you.

Your radiotherapy team

You will meet many different specialists from your radiotherapy team. You may see them before, during and after radiotherapy treatment.