Effects on sex life and fertility

The treatments for cancer of the womb may affect your sex life, but many of these effects can be prevented or treated. CancerBACUP has further information on sexuality and cancer.

If you have had a hysterectomy and your ovaries have also been removed, or if you have had radiotherapy to the pelvis, you will experience menopause symptoms (if you have not yet had the menopause). These can include hot flushes, dry skin, dryness of the vagina and possibly feeling low, anxious or less interested in sex for a time. Many of these symptoms can be eased by hormone creams or tablets, prescribed by your specialist. These replace the hormones that would have been produced by the ovaries. Some doctors do not like to prescribe these hormones due to a theoretical risk that they could cause the cancer to come back, but there is no evidence that the hormones increase the risk of recurrence.

If dryness of the vagina is a problem, your GP or specialist can prescribe creams or Vagifem pessaries, or you can buy lubricating gels such as KY Jelly or Replens from the chemist. You or your partner can apply the gels or creams directly to the penis or vagina before or during sex.

Radiotherapy to the pelvis can cause the vagina to become narrower and this can make sex difficult or uncomfortable. The key to overcoming this problem is to keep the muscles in the vagina as supple as possible. Hormone creams (available on prescription from your doctor) applied to your vagina can help, but regular sex, or use of a vaginal dilator, is often the easiest and most effective treatment.

Many women feel nervous about having sex soon after treatment for cancer, but it is perfectly safe. Sex won’t make cancer worse and your partner can’t ‘catch’ cancer from you. Women often find they need to take more time over sex to help the vagina relax. It may also be easier if your partner is very gentle at first so that your vagina can stretch slowly. Regular gentle sex will help the vagina to regain its suppleness and you should be able to resume your usual sex life a few weeks after radiotherapy.

Vaginal dilators are usually made of plastic and the nurses on the ward, your specialist nurse or your specialist can give one to you. The dilator needs to be gently and regularly inserted into the vagina to stretch it gradually and prevent narrowing. The nurses or your doctor can show you how to use a dilator and can answer any questions. Try not to be embarrassed about asking for or using a dilator. Many women find them very useful to improve the suppleness of the vagina after radiotherapy, even if they have a regular partner. A dilator can be helpful for women who may have temporarily lost interest in sex due to menopausal symptoms, or who feel nervous of having sex soon after treatment, or who do not have a regular partner.

Surgery and radiotherapy for cancer of the womb will prevent you from being able to have children in the future.

Younger women and those who were hoping to have children or complete their family may be especially upset if they have needed a hysterectomy or had radiotherapy that has damaged their ovaries.

Women who have had their menopause may also feel a deep sense of loss after an operation for cancer of the womb. Some women feel that the removal of their womb takes away part of their womanhood and they feel less feminine. It can help if you give yourself plenty of time to grieve for children you might have had, or to mourn, as the loss of the womb is felt by many women to be a bereavement.

You may find it helpful to talk to a specialist gynaecological oncology nurse or a counsellor who is specially trained to listen and offer support. CancerBACUP’s CancerBACUP’s Cancer Support Service can tell you more about counselling and can let you know what is available in your area.