Changes to the vagina

Glossary

Some cancer treatments may change the vagina, which can cause discomfort and/or pain during intercourse.

Shortening and narrowing of the vagina – Surgery may shorten the vagina, and radiation therapy to the pelvis can narrow the vagina. You may be advised to use a vaginal dilator after treatment ends. This is a tube-shaped device made from plastic or silicone. You insert the dilator into the vagina for short periods of time to gradually widen the entrance and prevent the side walls sticking together.

If you have any concerns about using a vaginal dilator, ask your health care team for a referral to a pelvic health physiotherapist.

Tight vaginal muscles – After cancer treatment, some women experience vaginismus, when the muscles around the vagina become tight. This is often caused by fear that intercourse will be painful, and can make penetration difficult. Ask your health care team for a referral to a pelvic health physiotherapist, who can help you learn how to keep the muscles relaxed during intercourse.

Vaginal dryness – A lack of oestrogen often causes vaginal dryness, which can make penetration during sex painful. You may also be more likely to get vaginal infections, such as thrush.

Thrush (candida) – Thrush can occur when genital dryness causes an overgrowth of a yeast-like fungus that is commonly found in the vagina. It can cause itching, burning and an unpleasant discharge, and may make intercourse painful.

Loss of sensation – Some women experience a loss of sensation in their vagina temporarily or permanently, depending on the type of treatment they have had. This can make sex uncomfortable or unsatisfying, or may cause low libido and arousal.

Learn tips for coping with these vaginal changes.

Vaginal health

When treatment leads to changes in the vagina, women may need both vaginal lubricants and vaginal moisturisers to prevent discomfort and pain. Some women can also use oestrogen-based creams. Avoid products containing perfumes, oils or glycerine.

Vaginal lubricants (personal lubricants) – These are liquids or gels that are applied around the clitoris and labia and inside the vaginal entrance during sexual activity. You can buy water-based or silicone-based lubricants at supermarkets and chemists. Lubricants with a silicone base may last longer than the water-based ones. Petroleum-based products (e.g. Vaseline) are not recommended as they can increase the chance of developing a vaginal infection.

Vaginal moisturisers – These non-hormonal, over-the-counter products help to restore lubrication and the natural pH level to the vagina and vulva. They are usually used 2–3 times per week.

Vaginal oestrogen therapy – Pessaries or creams can help restore oestrogen levels in the vagina and relieve discomfort. These may not on if you are having hormone therapy for cancer.

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Instructions for downloading and reading EPUB files

Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

Need more help? Visit: http://support.apple.com/kb/HT4059

Kobo

To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3

Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/

Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630

Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.

This information was last reviewed in May 2019
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