Sexual side effects of cervical cancer treatment

If you have not gone through menopause, you may experience menopausal symptoms after your treatment. These include hot flushes, night sweats, dry skin, vaginal dryness, decreased sex drive (low libido), low mood, poor concentration and difficulty in sleeping. You might get these symptoms if your ovaries are affected by treatments such as:

• Radiotherapy to your pelvic area (unless you had your ovaries moved (transposed) before treatment)
• Certain chemotherapy drugs
• Surgery to remove your ovaries (this treatment is rare but will definitely cause early menopause)

Hormone replacement therapy (HRT)

Most of the menopausal symptoms can be prevented or reversed by replacing the hormones that your ovaries previously made using hormone replacement therapy (HRT) drugs.

If you are younger, it is very important that these hormones are replaced to protect your bones and improve menopausal symptoms.

You may not be suitable for HRT if:

• You have a family history of breast, ovarian or womb cancer, as the hormones may encourage these cancers to grow. 
• Have a history of blood clots, heart disease or stroke
• Have untreated high blood pressure – you will need to have medication to treat this before starting HRT
• You have liver disease
• You are pregnant

Read more about managing menopausal symptoms.

Radiotherapy to the pelvis can cause vaginal dryness. This can make having sex uncomfortable. Vaginal lubricants can help with day-to-day dryness. Water-based or silicone vaginal lubricants can be used during sex. Hormonal creams can also help with vaginal dryness. 

Your doctor or nurse specialist can give you advice about the best products to help. 

Radiotherapy might shorten or narrow your vagina. Also, the walls of the vagina can become less stretchy and drier than before treatment. This can make sex uncomfortable. 

Regular gentle sex or using a special device called a dilator can help with this. Your nurse specialist will recommend that you use vaginal dilators – phallic (penis) shaped and made from silicone – to try to prevent these vaginal changes from happening.

Your specialist nurse can give you lots of advice in this area – try not to feel embarrassed or uncomfortable to talk about it. They will understand your concerns and will always respect your feelings.

You may feel tender or sore for a few weeks after surgery or radiotherapy. You may want to avoid sex for a few weeks to allow the area to heal fully and avoid any further damage. 

• Give yourself time to recover, and don’t rush into sex if you don’t feel ready. 
• It may help to talk openly to your partner or a counsellor about how you’re feeling. 
• Talk to your specialist nurse if you’re worried about your sex life or sexual side-effects. Try not to feel embarrassed. They will be happy to talk to you and give you advice.
• It may be useful to become more aware of your vaginal muscles and learn how to relax your muscles when you are having sexual intercourse.
• If having sex is uncomfortable try different positions. Lying on your side or having your partner underneath you may be easier. 
• You should use contraception to prevent pregnancy during and after radiotherapy or chemotherapy. You may still be fertile during chemotherapy - even if your periods stop, and you may be fertile for a short time after starting radiotherapy. Your doctor will advise you about contraception.