Pain

After surgery you may feel sore for several weeks or longer in some cases. You may find it uncomfortable to be touched or hugged if the wounds from the surgery are still healing or if the area around the scar is painful. Pain can reduce your interest and pleasure in sex and distract you from reaching orgasm. It may also mean the positions you enjoyed having sex in are now uncomfortable or you may be worried about hurting your partner. The medicines you are taking may make you feel drowsy and tired, which may affect your libido.

Painful intercourse

Irritation of the prostate or urethra from surgery or radiation therapy can cause painful orgasms. If you have developed scar tissue in the penis after surgery, this may cause pain or bleeding, but it usually settles down in time. Anal sex can be painful after radiation treatment for prostate or anal cancer.

Pelvic surgery, radiation therapy or treatment that affects hormones can reduce the size or moistness of the vagina, which can make intercourse painful. Fear of pain can cause the muscles around the vagina to become tight (vaginismus), and this can make penetration difficult or impossible.

After my big operation I had quite a bit of pain and I would just basically either take the pain medication that they give you or just try and get into a comfortable position with the pillows around you.

— Annmaree

Tips for managing pain

Managing pain

Making penetrative sex more comfortable

Plan sexual activity for the time of day when your pain is lowest. If you are using pain medicine, take it shortly before sex so it will have maximum effect.
Try different positions (such as side by side) until you find one that may be more comfortable for both of you and reduces pressure on painful areas.
Use pillows or cushions to help you feel more comfortable and reduce pressure on a sore area.
Use relaxation techniques such as warm baths or massage to relax you before having sex.
If pain continues, you can ask to be referred to a specialist pain clinic. It is important to deal with pain early as a holistic approach is important for long term benefits.

Avoid deep pelvic thrusts – choose alternative positions to control the depth of penetration.
Use plenty of water-based or silicone-based lubricant, e.g. Pjur or Astroglide.
Try to be close to orgasm before penetration.
Talk to a doctor or sex therapist if these methods don’t work. A women’s pelvic health physiotherapist may be able to advise on the use of vaginal dilators and pelvic floor exercises to help manage painful intercourse.
Ask an occupational therapist what products can assist with positioning – they may suggest using wedges, pillows, electric beds, transfer boards.
If pain is ongoing, ask to be referred to a specialist pain clinic.

For more on this, see Pain and cancer or listen to our Managing Cancer Pain podcast.

Listen to our podcast on Sex and Cancer

This information was last reviewed in May 2019. View who reviewed this content.

Helena Green, Clinical Sexologist and Counsellor, inSync for Life, WA; Anita Brown-Major, Occupational Therapist, Thrive Rehab, VIC; Karina Campbell, Consumer; Nicole Kinnane, Nurse Consultant, Gynae-oncology Services, Peter MacCallum Cancer Centre, VIC; Jessica Medd, Senior Clinical Psychologist, Headway Health and Concord Hospital, NSW; Chris Rivett, 13 11 20 Consultant, Cancer Council SA; Kath Schubach, Urology Nurse Practitioner, President – Australia and New Zealand Urological Nurses Society (ANZUNS), VIC; Prof Jane Ussher, Chair, Women’s Health Psychology, Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, NSW; Maria Voukelatos, Consumer. We would like to thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.

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