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Women's sex life and fertility after radiotherapy

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This page tells you about the effects of radiotherapy on a woman's fertility and sex life. There is information about


Radiotherapy and your fertility

Radiotherapy to the lower part of the abdomen in premenopausal women usually causes the menopause. So the ovaries stop producing eggs and the female sex hormones. Radiotherapy also affects the womb, so that it is not possible to have children afterwards. It is occasionally possible to move the ovaries out of the treatment area by surgery before radiotherapy begins. The eggs can then be used for fertility treatment and surrogate pregnancy afterwards, but this is very rare.

After radiotherapy to the pelvis (lower abdomen), over a few weeks you will have the signs of the menopause

  • Hot flushes and sweats
  • Dry skin
  • Dryness in the vagina
  • Loss of energy
  • Irregular or no periods
  • Less interest in sex
  • Moodiness or feeling low

Before you have radiotherapy, your radiotherapy doctor (clinical oncologist) will discuss the possibility of infertility with you. You'll usually be asked to sign a form saying that you agree (consent) to have the treatment and that you understand the side effects.

Your doctor may prescribe hormone replacement therapy (HRT) to help overcome the symptoms of the menopause. There is information about coping with hormone symptoms in the coping with cancer section. And the Women's Health Concern organisation produces a leaflet called The Menopause which has tips on coping with the changes it causes.

Going into an early menopause can be very upsetting. It may help to talk over your fears and worries with your partner or a friend. Try to talk to the radiotherapy staff too if you are having problems. The Cancer Research UK nurses or some of the women's organisations on our general organisations list can give information and advice about how to cope with an early menopause.


Radiotherapy and your sex life

Radiotherapy to the lower abdomen can make the tissues in the vagina stiffer and less stretchy over time. This is called fibrosis and can affect your sex life. The fibrosis can shorten and narrow your vagina. To try to prevent or minimise this, it is important to start using vaginal dilators after the radiotherapy treatment. If you don't use these, it can be difficult to have sex comfortably after your treatment.

Dilators are tube shaped objects, made of plastic or metal. They come in different sizes. You usually start using them from anything between 2 to 8 weeks after your radiotherapy ends. This varies depending on your radiotherapy centre.

You put the dilator into your vagina gently for about 5 to 10 minutes about 3 times a week. It stretches the vagina and helps to stop it from narrowing. It is important not to force this. If you find it difficult to get the dilator in, you should switch to a smaller size. You may find it easier with a water soluble lubricant such as Astroglide or to use a moisturiser such as Replens. You can use the dilator in the bath if you prefer.

If you find the dilator you have been using is getting a tighter fit, you may need to use it more often. Talk to your doctor or nurse first. You may find that you have slight bleeding or spotting after using your dilator. This is normal. It isn't normal to have heavy bleeding or pain. If you have either of these effects, stop and contact your doctor or nurse. You may need to carry on using the dilators for life. But if you are having sex at least twice a week, you don't need to continue to use the dilators.

After radiotherapy to the lower abdomen, some women have vaginal dryness and pain during intercourse. Ask your doctor or specialist nurse for advice if you have this problem. You may be able to have hormone cream or hormone replacement therapy (HRT), which can both help. There is detailed information about the effects of radiotherapy on your sex life in the section about sex and cancer for women.

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Updated: 4 July 2012