It can help to know about the different parts of the sex organs and their names so that you know what we’re talking about in this section.
diagram showing a girlas reproductive system. It is in the lower half of the abdomen and shows the two ovaries on either side of the abdomen. These are connected to the womb, or uterus, by fallopian tubes. At the base of the womb is the cervical canal, cervix and vagina. Behind the womb is the bladder.
In girls and young women, the pelvic area includes the sexual organs, the bladder, and the lower part of the bowel.
It’s not common for cancer or its treatment to make it physically difficult to have sex but it does happen occasionally.
Possible effects
- Some treatments can cause vaginal dryness. This may be due to low levels of the female hormone, oestrogen. Sometimes the ovaries need to be removed as part of treatment for cancer and this causes lower oestrogen levels due to an early menopause (when your periods stop permanently).
- Radiotherapy to the pelvic area may stop the ovaries producing oestrogen. An early menopause can also be caused by treatment that affects the gland in the brain called the pituitary gland. The pituitary gland produces hormones that control the production of oestrogen by the ovaries.
- If you have had surgery to your vagina, which has made it narrower or shorter, this can make sex uncomfortable, though this is very rare. In a small number of women, the vagina may have been removed completely and this will obviously make it impossible to have penetrative sex.
- Damage to the nerves from pelvic surgery or radiotherapy can reduce the ability to feel pleasure during sex and reach orgasm.
- Lowered levels of oestrogen may reduce your interest in sex.
- If you have had treatment for bone or muscle tumours in your limbs or back, this can sometimes make it more difficult to get into position to have sex.
- Pain, whatever its cause, can make having sex more difficult.
- Many young people with cancer say that they feel 'washed out' and as though they have no energy for many months or even longer. If this happens to you, you may lose your interest in sex, feel unattractive or worry that you will never be able to be sexually active.
- These feelings may also happen due to changes in your body after cancer and treatment.
what can help?
There are often ways of dealing with the physical effects of treatment on your sex life. There is also plenty of expert advice you can tap into. It is important to give yourself plenty of time to recover if your treatment has been recent. If you are worried and want to talk to someone, it is fine to ask for advice at any time.
If you have a dry vagina, this can be treated by using a cream or gel on the inside lining of your vagina. These can be bought from a pharmacist or prescribed by your GP.
If surgery or radiotherapy has made your vagina narrower, your doctor or specialist nurse may suggest that you use vaginal dilators. These are plastic, or glass, tubes of varying sizes which you insert gently into the vagina to stretch it.
A doctor or nurse will show you the dilators and explain how to use them. They are designed to very gently and gradually stretch the vagina and can be very effective. Although this may seem very strange it sounds worse than it is.
When hormone levels have been lowered by treatment in young men or women, the hormone levels can usually be kept at almost normal levels by taking hormone tablets, or using skin patches or, sometimes, having injections.
If you are put off having sex because you have pain, it is worth checking with your doctor if there is anything that can get rid of or lessen the pain. You can also experiment with sexual positions that may be more comfortable for you.
Perhaps the most important thing to realise is that your problems will be ones that other young people treated for cancer have had, and that getting help may solve or reduce these difficulties.
