Vaginal narrowing and dryness

Radiation therapy to the pelvic area can cause vaginal tissue to lose its elasticity and shrink, narrowing the vagina (vaginal stenosis). If your ovaries were removed, your vagina may also become very dry. These side effects may make vaginal examination by a doctor uncomfortable or difficult, and may make it painful to have sex.

Your treatment team may recommend using a vaginal moisturiser or lubricant (available over-the-counter from pharmacies) or a hormone cream (available on prescription and safe with many uterine cancers). They may also advise you to start using vaginal dilators (or have regular sexual intercourse) some weeks after radiation therapy ends.

Tips for using vaginal dilators

• Vaginal dilators are tube-shaped devices made from plastic or silicone. They come in different sizes and may help keep the vaginal walls open.
• Ask your treatment team if they will provide the dilators or where you can buy them. Your team will explain when and how to start using the dilators.
• Make sure any soreness or inflammation has settled down before you start using dilators. This will usually be 2−6 weeks after your last session of radiation therapy.
• Start with the smallest dilator and move up sizes as each becomes more comfortable.
• Find a private place. Using a water-based lubricant, slowly insert a dilator into the vagina. Leave it for 5–10 minutes. Do this once or twice a day for the first few months, and then 2−3 times per week for several months after that, as advised by your team.