Vaginal stenosis
Vaginal stenosis is the narrowing or loss of flexibility of the vagina, and it occurs as a side effect of radiotherapy or genital surgery. In most cases, it is also accompanied by vaginal dryness and loss of resilience of scar tissue.
Radiation therapy is generally used in the pelvic area in order to treat cancer of the bladder, rectum, lymph glands, as well as gynaecological cancers. Whatever the type of radiotherapy - by external beam radiation or by the use of internal implants - pelvic radiation therapy has multiple effects on the vagina.
The most common side effects include:
- Vaginal dryness and thinning of the vaginal lining
- Fibrosis (formation of scar tissue)
- The shortening and narrowing of the vagina
- A reduction of vaginal lubrication
- A reduction in the size, and number of small blood vessels within the vagina
In the long term, vaginal stenosis can lead to pain during physical examination and problems with sexual intercourse. In order to reduce these side effects, patients are advised to use a silicone vaginal dilator. Sometimes, doctors also recommend vaginal moisturisers, oestrogen creams and exercises to increase circulation in the vaginal area.
If your healthcare professional allows sexual activity, they’ll likely suggest using a water-based lubricant to help with penetration and protect your dry vaginal tissue. You may also be encouraged to try different positions to improve comfort and protect your vaginal tissue. Studies show that vaginal penetration - whether through the use of a silicone vaginal dilator or during intercourse can significantly reduce the chances of developing vaginal stenosis and dyspareunia (painful sex).1
There may be times, especially towards the end of your treatment, when sexual intercourse becomes too painful due to vulvar and vaginal inflammation. If this happens, it’s recommended to use vaginal dilators or give your body time to heal before resuming normal sexual activity.
If you're dealing with vaginal stenosis, it's completely understandable that you may lose interest in sexual activity during and after treatments like radiotherapy. This loss of interest is often tied to a loss of confidence, but know that you’re not alone, and there are ways to manage this.
It's also essential to recognise that radiotherapy in the pelvic area can have emotional side effects that may affect your quality of life. This is why, along with physical care, seeking counselling, aftercare, and support is important - it can help significantly with issues related to body image and sexual function.
Please know that you're not alone in this, and there are resources and professionals to support you every step of the way. If you have any questions or need further support, don't hesitate to contact us.
Reference
- Liu M, Juravic M, Mazza G, Krychman ML. Vaginal Dilators: Issues and Answers. Sex Med Rev. 2021;9(2):212-220.
