I am aware that to simply state that cancer 'is a life changing experience' does not fully describe the experience of a cancer diagnosis and treatment and unfortunately for many this journey does not end with remission.
Life after cancer comes with a host of physical, emotional and psychological challenges and this is certainly true for those who have undergone treatment in the pelvic region. Treatments like radiation, surgery and chemotherapy can have long-term effects on various aspects of health, including sexual function and pelvic health. Understanding these late effects and how they impact sexual well-being is vital for both survivors and their partners.
Understanding Pelvic Radiation Disease
Pelvic cancer treatments target cancers in areas like the colon, anus, bladder, rectum, cervix, uterus and ovaries. While these treatments are often successful in controlling cancer, they can leave lasting damage to the pelvic organs, muscles and nerves, leading to what is known as Pelvic Radiation Disease or pelvic late effects. These effects might not appear until months or even years after treatment, but when they do, they can affect daily life in several ways, for example:
- Bladder and bowel dysfunction: Treatments like radiation therapy can cause irritation or scarring of the bladder and intestines, leading to issues such as urinary incontinence, urgency, pain or bowel changes such as diarrhoea or constipation, incontinence, passing wind or bowel cramps.
- Pelvic pain and tightness: Scar tissue or damage to nerves and muscles in the pelvic area may result in pain, stiffness, or a reduced range of motion in the hips and lower back.
- Lymphoedema: Some cancer treatments can damage the lymph nodes, causing painful swelling in the legs, genitals, or lower abdomen.
- Vaginal dryness and loss of elasticity: For women, pelvic radiation can cause vaginal tissue to become thin, dry, or less elastic, which may affect intimacy and comfort during sex.
- Vaginal Shortening: Surgery may result in a physically shortened vagina and radiotherapy may result in loss of natural elasticity of the vagina.
While these late effects can feel overwhelming, they are not insurmountable. With the right support, many survivors find ways to manage them and continue living fulfilling lives. It is really important to find the right healthcare professional to support you with treating these side effects. The Pelvic Radiation Disease Association may be able to help connect you to the right healthcare professional to support you.
How Pelvic Late Effects Impact Sexual Health
Sexuality is often an essential part of a person's identity and intimate relationships. Unfortunately, pelvic late effects can disrupt sexual function and lead to discomfort, reduced libido, and emotional distress. You may find yourself having to address a range of concerns
Physical Discomfort or Pain:
- Vaginal dryness, scarring, or narrowing can make intercourse painful for women, while pelvic floor dysfunction may also lead to pain during sex.
Changes in Libido:
- Fatigue, hormonal imbalances and emotional strain after cancer treatment can lower libido in both men and women.
- Hormone therapy, which is common for some types of cancer (such as breast cancer), may reduce interest in sex.
- Survivors may feel self-conscious about scars, managing a stoma, changes in their physical appearance, or changes in their genital function, which can all affect self-esteem and comfort during intimate moments.
- Some may experience anxiety about their ability to satisfy their partner or fear of rejection.
- It may be difficult to overcome the change in roles in a relationship as you move from ‘patient and carer’ to partners once again.
Reclaiming Your Sexual Health After Cancer
While pelvic late effects can be challenging, they don’t have to put an end to your sex life or intimacy. Successfully navigating these issues can take you towards a fulfilling sexual life post-cancer:
Open Communication:
Talk openly with your partner about how you feel and what you’re experiencing. It’s important to share your concerns and desires to maintain a close connection.
Be honest with your healthcare provider as well. They can offer practical advice and refer you to specialist clinics.
Seek Professional Help:
It is important to get medical advice and support from specialists. You may require a referral to specialist clinic or healthcare professional such as a gastroenterologist, pelvic physiotherapist, psychosexual therapist or nurse specialists who understands pelvic late effects.
Hormonal Treatments, Moisturisers or Lubricants:
For women experiencing vaginal dryness, local hormone replacement therapy may be an option to manage the menopausal side effects of cancer treatment. For non-hormonal alternatives we always recommend the YES YES range of moisturisers and lubricants. They are designed to be irritant free and are pH and osmotically matched to the vagina. This is really important as the tissues of the vulva and vagina may be particularly sensitive after treatment. For temporary pain relief Releveum is a real hero product to promote healing with 4% lidocaine which is a local numbing agent.
Explore New Intimacies:
Redefine what intimacy looks like. Sex doesn’t have to be limited to intercourse. Physical touch, massages, or simply spending quality time together can strengthen emotional and physical bonds.
Try new forms of intimacy that accommodate your body’s current capabilities, we designed Kaito Sky, a soft, smooth, vibrator to allow individuals to safely explore external massage and pleasure.
If deep penetration has become uncomfortable Ohnut is our intimate wearable worn at the base of the penis or dilator to help control penetration depth making sex comfortable and enjoyable for all.
Dilators
Vaginal dilators are medical devices designed to gently stretch, prevent narrowing and gradually improve the flexibility of the vaginal canal. Our soft flexible Soul Source dilators are designed to be kinder than rigid plastic alternatives. To read more about how to incorporate dilators into your rehabilitation read out blog here.
Stay Positive and Be Patient:
Recovery from pelvic late effects takes time, and it’s important to remain patient and compassionate with yourself. Healing and reclaiming sexual function may happen in stages, but with time and effort, progress is possible.
Empowerment Through Knowledge and Support
No one should feel isolated in their experience of pelvic late effects and sexual health challenges after cancer. Empower yourself by seeking out educational resources, connecting with support groups, and finding healthcare providers who understand the nuances of survivorship.
Sexual health is an integral part of overall well-being, and addressing these concerns with the same care and attention as other aspects of post-cancer life can help you reclaim your body, your confidence, and your sense of pleasure.
