Women's sex life and fertility

Radiotherapy to your lower tummy (abdomen) or pelvis can affect your fertility and sex life.

Fertility

The ovaries are in the lower part of your abdomen, in the area between your hips (the pelvis).

Radiotherapy to this area may affect your womb and can stop your ovaries from working. If you haven’t already been through the menopause, this means your periods stop and you won’t be able to become pregnant (you become infertile).

The risk of infertility depends on the dose of radiation to your ovaries, your age (the risk is higher the older you are), and if you have chemotherapy with the radiotherapy.

Finding out that treatment for your cancer may leave you infertile can be extremely distressing if you had hoped to get pregnant in the future. Your doctor and nurse will support you and talk about possible options.

It is sometimes possible to move the ovaries out of the treatment area before radiotherapy begins. This is called ovarian transposition. It is usually done by keyhole (laparoscopic) surgery. Ovarian transposition may prevent an early menopause.

You can see a fertility specialist before you start cancer treatment. They can talk to you about the possibility of freezing your eggs, embryos or ovarian tissue. You could possibly use your eggs in the future if you wanted to try to have a child through a surrogate (another woman carries the developing baby).

Menopausal effects

Symptoms of the menopause often start during your course of radiotherapy or shortly afterwards. Symptoms include:

• hot flushes and sweats
• dry skin
• dryness in the vagina
• loss of energy
• irregular or no periods
• less interest in sex
• mood changes or feeling very sad

There are some things that can help to relieve menopausal symptoms. These include: 

• hormone replacement therapy (HRT) - replaces hormones that are at lower levels due to menopause
• hormone cream - oestrogen vaginal cream can help with vaginal dryness

Your emotions and menopause 

Going into early menopause can be very upsetting. It can help to talk over your fears and worries with your partner or a friend. Try to talk to your radiotherapy team or specialist nurse if you are having problems. 

Some of the women’s organisations on our general organisations list can also give help and support.

Your sex life

Pelvic radiotherapy can make the tissues in your vagina less stretchy. This is called fibrosis. Fibrosis can narrow the vagina, making it uncomfortable and difficult to have sex and vaginal examinations in the future. 

Using vaginal dilators after treatment might help to prevent this. The advice to start using dilators varies depending on the radiotherapy centre; ask your radiographer, doctor or nurse about dilators. 

Using dilators

Dilators are smooth tube shaped objects with a rounded end, made of plastic or metal. They come in different sizes. You start with the smallest size first.

For the first 6 months 

Use dilators with a water soluble lubricating gel at least twice a week and up to twice a day, for 3 to 10 minutes each time.

Between 6 and 12 months

Use dilators once a week.

After 12 months

Use your dilators occasionally as long as you are not having any difficulty.

Alternatives to vaginal dilators

Sexual intercourse also helps to keep the vagina open and is a good alternative to using dilators.

You might prefer to use your fingers or a vibrator to help stretch your vagina. If water soluble lubricants do not give enough lubrication for comfortable intercourse you may want to try a silicone based lubricant. These give more lubrication and are usually fine to use after any vaginal irritation caused by radiotherapy has settled down.

A small amount of bleeding is usual when you first start using a dilator but contact a health professional if you have a lot of bleeding or pain.