CANCER OF THE WOMB (UTERUS)

( By JASCAP )

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After treatment

How treatment for womb cancer may affect your sex life and fertility

The treatments for womb cancer may affect your sex life, but many of these effects can be prevented or treated.

Menopausal symptoms
Narrowing of the vagina
Sex after treatment
Vaginal dilators
Fertility

Menopausal symptoms

If you have had a hysterectomy and your ovaries have also been removed, or if you have had radiotherapy to the pelvis, you will have menopause symptoms (if you have not yet had the menopause). These can include:

hot flushes
dry skin
dryness of the vagina
feeling low and anxious
being less interested in sex for a time.

Many of these symptoms can be eased by hormone creams or tablets, prescribed by your specialist. These replace the hormones that would have been produced by the ovaries. Some doctors do not like to prescribe these hormones due to a theoretical risk that they could cause the cancer to come back, but no studies so far have shown this to be the case.

If dryness of the vagina is a problem, your GP or specialist can prescribe creams or Vagifem® pessaries, or you can buy lubricating gels, such as K-Y Jelly® or Replens®, from the chemist. You, or your partner, can apply the gels or creams directly to the penis or vagina before or during sex.

Narrowing of the vagina

Radiotherapy to the pelvis can make the vagina become narrower and this can make sex difficult or uncomfortable. The key to overcoming this problem is to keep the muscles in the vagina as supple as possible. Hormone creams (available on prescription from your doctor) applied to your vagina can help, but regular sex, or use of a vaginal dilator, is often the easiest and most effective treatment.

Sex after treatment

Many women feel nervous about having sex soon after treatment for cancer, but it is perfectly safe. Sex wonít make cancer worse and your partner canít catch cancer from you. Women often find they need to take more time over sex to help the vagina relax. It may also be easier if your partner is very gentle at first, so that your vagina can stretch slowly. Regular, gentle sex will help the vagina to become supple again and you should be able to go back to your usual sex life a few weeks after radiotherapy.

If sex is difficult, you and your partner might find it helps to discuss things with one of your treatment team. Although it might feel embarrassing at first, it can really help to talk things through. Your nurse or doctor will have experience in this area and can advise you about what might help.

Vaginal dilators

Vaginal dilators are usually made of plastic and your nurse or doctor can give a set to you (dilators usually come in sets of different sizes). A dilator needs to be gently and regularly inserted into the vagina to stretch it gradually and prevent narrowing. The nurses or your doctor can show you how to use the dilators and answer any questions. They are used to discussing these issues, so you donít need to feel embarrassed.

Many women find dilators very useful to improve the suppleness of the vagina after radiotherapy, even if they have a regular sexual partner. A dilator can be helpful for women who may have temporarily lost interest in sex due to menopausal symptoms, or who feel nervous about having sex soon after treatment, or who do not have a regular sexual partner.

Fertility

Surgery and radiotherapy for womb cancer will prevent you from being able to have children in the future. Younger women, and those who were hoping to have children or add to their family, may be especially upset if they have needed a hysterectomy, or had radiotherapy that has damaged their ovaries.

Women who have had their menopause may also feel a deep sense of loss after an operation for womb cancer. Some women feel that the removal of their womb takes away part of their womanhood and they feel less feminine. It can help if you allow yourself time to grieve for children you might have had, or to mourn, as the loss of the womb can give many women a feeling of bereavement.

You may find it helpful to talk to a specialist gynaecological oncology nurse, or a counsellor, who is specially trained to listen and offer support.

Follow up after treatment for womb cancer

After your treatment is completed you may need to have regular check-ups at the hospital. Your doctor or specialist nurse will tell you how long you will need to have these. Many women find that they get very anxious for a while before their appointments. This is natural and it may help to get support from family, friends, or a support organisation during this time.

If you have any problems, or notice any new symptoms in between follow-up appointments, let your doctor know as soon as possible.

For people whose treatment is over apart from regular check-ups, our booklet on adjusting to life after cancer treatment, gives useful advice on how to keep healthy and adjust to life after cancer.

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