Women who have surgery to remove the uterus, ovaries, bladder,
colon/rectum, or other organs in the abdomen or pelvis may experience more
sexual dysfunction than women treated for other cancers. Surgery may decrease in
the size or structure of the vagina which may result in pain during intercourse.
Vaginal discomfort may be caused by vaginal dryness or loss of stretch of the
vaginal tissues that may make penetration uncomfortable. Patients who receive
radiation therapy to the pelvic region or radiation implants may need to use
vaginal dilators on a regular basis to prevent scar tissue and closure of the
vagina. Patients who are postmenopausal may experience a decrease in natural
lubrication of the vagina. There are some effective treatments available. Some
doctors recommend:
- Use extra lubrication to reduce pain.
- Use only water based lubricants.
- Many women prefer lubricants such as Astroglide, Moist Again, the Women's
Health Institutes Lubricating Gel, and Probe over other products because
they spread easily and last longer.
- Avoid petroleum based lubricants, particularly if your partner is using
condoms that can be damaged with this type of lubrication.
- Avoid scented lubricants as these may irritate the genital tissues.
- Use lubricants during foreplay and spread generously over labia, clitoris,
and into vagina. Also spread lubrication on any object that will enter the
vagina.
- Keep lubricants close to the bed or anywhere sexual activity may occur.
- Consider using Replens which is designed to moisturize the walls of the
vagina. It is used about 3 times per week at bedtime.
- If your radiation oncologist has prescribed vaginal dilators, make sure
you use them as instructed.
Women should discuss their concerns with their doctors.
Sources:
OncoLink has specific patient information for sexuality issues for women
with gynecologic cancers [use the search term "sexuality" from the
main search menu.]
Metz, MD, James, Dealing with vaginal discomfort
during intercourse after cancer treatment, University of Pennsylvania Cancer
Center, 1998
