Cancer, Sex and You

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Pre and Post Cancer Treatments – Ovarian, Uterine and Vaginal Cancer

The effects of chemotherapy can vary from person to person. It is possible for chemotherapeutic drugs to affect a woman’s estrogen, progesterone and testosterone levels leading to symptoms such as hot flashes, bone weakening, mood changes, sleep disturbances and skin changes that extend to the lining of the vagina. Specifically, the vagina can become dry and inflamed.  It is also common for women to experience vaginal yeast infections due to the additional use of steroid medications and antibiotics during cancer treatment. Yeast infections that occur during chemotherapy must be treated right away since the body’s immune system may already be compromised.

Radiation therapy may be the sole cancer treatment, or it may be used in combination with chemotherapy. Radiation directed anywhere in the pelvis can cause fatigue, upset stomach and diarrhea. Radiation can also cause early menopause with all of its signs and symptoms. The normal skin of the vagina is often effected by radiation resulting in vaginal itching, burning and dryness. The vaginal lining also tends to become thin and fragile and is prone to vaginal sores, ulcers and scarring. The walls of the vagina may lose flexibility and become tough and fibrous which can lead to shortening of the vagina. When this happens, sexual intercourse can be painful.

Ironically, engaging in gentle, well-lubricated sexual intercourse at least 3-4 times per week can help alleviate adhesions by stretching the walls of the vagina. An alternative to intercourse is the use of a vaginal dilator, a rubber cylinder not unlike a large tampon that, over a period of 8-12 weeks, can effectively help stretch the vaginal walls making intercourse, and follow-up gynecological exams, possible.

While the cancer itself might not affect the patient's ability to have sex, it could wreak havoc on their desire and ability to feel desirable, both primary motivators for engaging in sexual activity. While undergoing cancer treatment, it is natural to experience feelings of discouragement, depression, sadness and anger. It is important for one to discuss these feelings with the doctor so he or she can make the appropriate referral to a psychotherapist, psychologist or sex therapist. Many patients, and their spouses, have reported tremendous benefit from learning various coping skills, methods of stress reduction, improved communication skills and even alternate ways of making love and experiencing intimacy.


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