Navigating Vaginal Health Post-Cancer

Cancer in the vagina, vulva, rectum, bladder, ovaries, uterus or cervix can all have a huge impact on the functioning and health of your vagina, but usually this interruption to functioning is caused by the treatment, not the actual cancer.^1,2

These post-treatment problems are usually not well covered by your healthcare providers, who are more focused on the cancer itself and are not necessarily well-equipped to deal with the aftermath.

This means there is a gap between cancer treatment and a vagina that you can actually use for something other than hiding pens and small change in, if you’re lucky.

Cancer does not always go away. This section is for all women whose vaginas are affected in some way by cancer, or the people who love them. All vaginas need TLC, especially those heavily – or slightly – damaged by cancer and cancer treatments.

How cancer can affect your vagina or vulva

There are a number of cancers that will affect your vagina and vulva, because the treatment either damages your ovaries temporarily or permanently (chemo), and/or radiation treatments are applied vaginally, thickening and damaging vaginal tissue.^3,4

Surgery in the pelvis to remove cancerous tissue often requires removal of some surrounding tissue, which can mean part of your vagina or other reproductive organs must be fully or partially removed. This has repercussions, but everyone is a little different in which parts and how much needs to be treated.

Typical effects of cancer treatments can include, for weeks, months or long-term:

Changes to the shape and size of the vagina (usually narrowing or shortening)
Fatigue
Bowel and bladder interferences
Skin tenderness and soreness
Swelling
Early menopause
Infertility

Sex after cancer treatments

You may need help understanding and using vaginal dilators so that penetration is possible, and learning how to moisten and lubricate a dry vagina. ⁵

Resuming sex after cancer treatments can be complicated, but this will depend on what has happened to your body during treatments.^6,7 Your emotional state will also heavily influence how you feel about being intimate with another person.

We have some great tips on having sex with an ostomy.

More information

References

1.
Baral SK, Biswas P, Kaium MdA, et al. A Comprehensive Discussion in Vaginal Cancer Based on Mechanisms, Treatments, Risk Factors and Prevention. Front Oncol. Published online July 18, 2022. doi:10.3389/fonc.2022.883805
2.
Adams TS, Rogers LJ, Cuello MA. Cancer of the vagina: 2021 update. Intl J Gynecology & Obste. Published online October 2021:19-27. doi:10.1002/ijgo.13867
3.
Tsementzi D, Meador R, Eng T, et al. Changes in the Vaginal Microbiome and Associated Toxicities Following Radiation Therapy for Gynecologic Cancers. Front Cell Infect Microbiol. Published online October 27, 2021. doi:10.3389/fcimb.2021.680038
4.
Jensen PT, Groenvold M, Klee MC, Thranov I, Petersen MA, Machin D. Longitudinal study of sexual function and vaginal changes after radiotherapy for cervical cancer. International Journal of Radiation Oncology*Biology*Physics. Published online July 2003:937-949. doi:10.1016/s0360-3016(03)00362-6
5.
Mishra N, Singh N, Sachdeva M, Ghatage P. Sexual Dysfunction in Cervical Cancer Survivors: A Scoping Review. Women’s Health Reports. Published online December 1, 2021:594-607. doi:10.1089/whr.2021.0035
6.
Laganà AS, Garzon S, Raffaelli R, Ban Frangež H, Lukanovič D, Franchi M. Vaginal Stenosis After Cervical Cancer Treatments: Challenges for Reconstructive Surgery. Journal of Investigative Surgery. Published online December 10, 2019:754-755. doi:10.1080/08941939.2019.1695987
7.
Wang Z, Zeng A, Long F, et al. Use of Vaginal Reconstructive Surgery in Cervical Cancer Patients to Prevent Vaginal Stump Contracture. Journal of Investigative Surgery. Published online November 19, 2019:747-753. doi:10.1080/08941939.2019.1683658