Chemotherapy drugs are delivered in several ways, and the treatment can have a variety of implications on the vagina and surrounding tissues.
Each cancer is in a different spot, is a different size, and may be treated in its own right by your physicians. This means the fallout will be unique to each woman.
What can happen during chemo in the pelvic area
Bladder cancer chemotherapy treatments and your vagina/urethra
Sometimes the drugs are put directly into the bladder by catheter, inserted via the urethra. This has a very minor impact on that area, but trying to have sex too soon after treatment could cause discomfort.
Pelvic tumour chemotherapy treatments and your vagina
Pelvic tumours may be treated by pelvic infusion of chemo drugs via the major arteries that feed the pelvis (via the bloodstream). The long-term impact of this delivery method on your pelvic area isn’t really known yet. Short-term impacts are much like traditional IV methods.
Ovarian or colon cancer chemotherapy treatments and your vagina
Sometimes chemo will be given via intraperitoneal infusion, which means the drugs are put right into the abdomen. The space around the intestines and ovaries is filled up with chemotherapy drug, causing some abdominal swelling, after which the liquid is drained away. This can be quite uncomfortable, but this will dissipate.
Pregnancy and fertility outcomes of chemotherapy treatment
If you want to become pregnant later on, you should discuss this before you start treatment, because many chemotherapy drugs damage the ovaries, reducing oestrogen output. You may wish to get eggs removed and frozen, for later use. You will be advised to use some form of birth control to avoid getting pregnant during treatment, because most chemo drugs are toxic and will harm a foetus.
Speak to your doctor about how long you should wait after treatment to try getting pregnant.
Menopause (whether you like it or not) after chemotherapy due to ovarian failure
Sometimes chemotherapy can trigger early menopause, with associated symptoms, due to ovarian failure – that is, your ovaries stop working completely. Menopausal symptoms can include disruptions to vaginal moisture and natural lubrication, vaginal tissue deterioration, issues with vaginal tone, hot flashes, and interruptions or an end to your periods. You may bleed after sex or get spotting between periods.
Chemotherapy irritations to mucous membranes
Mucous membranes – like those in the vagina – are affected by some chemotherapy drugs. Your vagina can become dry and irritated, with more yeast infections. If you’re taking steroids or antibiotics, your yeast infection rate is likely to go up, with associated symptoms of burning, itching, discharge, and rawness.
Herpes or HPV virus flare-ups
Chemo can trigger a latent genital herpes or genital warts (HPV) flare-up, but only if you’ve had them previously. Your immunity is severely interrupted by chemotherapy, so see your doctor for help with a break-out.
Your libido on chemo
Women receiving chemotherapy are very likely to see a decrease in their sexual desire. Chemo is draining for lots of reasons, and these uncomfortable symptoms or side-effects can really put a damper on your sex life due to simple lack of energy. Your sexual desire is likely to return when you feel better, which might occur right near the next chemo session if your sessions are weeks apart.
Another obvious side-effect that puts a damper on things is hair loss, but there are other elements that aren’t always predictable that can interfere with body image and confidence, like weight gain and the omnipresent tubes that may stay in your flesh for weeks or months.