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Cervical Cancer

Sex and sexuality after cervical cancer

Both being diagnosed with cervical cancer and undergoing treatment can affect how a woman feels about herself sexually. Some treatments for cervical cancer, such as radiotherapy and hysterectomy, can cause physical changes which may affect a woman's sex life but many of these effects can be prevented or treated.

Many women we interviewed had felt very anxious about having sex after their treatment in case it would cause bleeding, be painful, or that it would feel very different to how it felt before treatment, or even that it might make the cancer return. Several said their partners had worried at first that they might hurt them. Some recently treated women were still facing these challenges, others had overcome their initial fears and had been able to rebuild their sex lives.

Radiotherapy to the pelvis can cause dryness or narrowing of the vagina. After some initial vaginal dryness or noticing that their vagina was narrower, most women who had only radiotherapy found that their sex life returned to normal. One woman explains how her sex life had improved after because she no longer had vaginal bleeding.

 

Comments that radiotherapy did not have any negative effect on her sex life.

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Age at interview: 36
Sex: Female
Age at diagnosis: 27
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Yes, mentally I think for a start because you're very aware it could be painful, it could be sore, you could affect something, you could bring on another tumour, so all those feelings are going on in your head but physically it wasn't painful at all actually. It wasn't, it wasn't uncomfortable. I was told in the beginning that I might lose the top of my vagina from my treatment, but it didn't feel any different for me. My husband said it didn't feel any different for him. Again, it was the release of not having the blood, it was just so different for me because I'd had that for a few years and suddenly it wasn't there. It was really good.

During a Radical or Wertheim's hysterectomy the vagina may be shortened. Some who had such an operation, or a trachelectomy, said that they had noticed only a slight physical difference when they first had sex, but not one that had a negative effect on their sex life.

 

Explains that her radiotherapy and hysterectomy had caused little difference to her sex life.

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Age at interview: 41
Sex: Female
Age at diagnosis: 39
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That hasn't been a problem, it's not been a problem. We've, me and my husband, we sort of resumed our sex life as soon as we could, and it was a bit frightening, it was a bit frightening because you don't know quite what its going to feel like. Especially because you know you're not quite the same as you used to be but it really, I mean for him, he said it didn't, it wasn't any different at all, other than a different sensation at the end, but it wasn't anything that was worse or better, it was different. And for me it didn't really make, it didn't make much difference, no. 

One said that she had experienced no difference in her sex life after her trachelectomy. Only a few mentioned that they had less intense orgasms or they had found sex slightly painful. A few commented that their partners had noticed a slight difference at the end of the vagina where it had been shortened or greater vaginal dryness, but it had not had a negative effect on their sex life.

 

She explains that she experiences less intense orgasms after her hysterectomy.

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Age at interview: 53
Sex: Female
Age at diagnosis: 51
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One thing that didn't go back to normal, and obviously never is going to be normal, is that, and I'll be very frank here, I know some women might not be as frank. Some women have orgasms from the womb and I have realised since my operation that I was one of the those women. It hasn't stopped. I mean I can still have clitoral orgasms but the other type of orgasm is very deep and very satisfying and I think not all women have them and I miss them . But they did say, I mean the nurse had said "You will still be able to have a sex life but it will feel different," I didn't realise that that was what she meant. I would've liked to perhaps have understood that a bit more. But then I mean I think I'm an intelligent woman and I know quite a lot about my body and I hadn't actually realised until after the op that I had orgasms from the womb and obviously anybody who has even an ordinary hysterectomy that is going to disappear. So it took a while and I mean I'm lucky, well I say I'm lucky I have a very patient loving understanding man. We are able to talk about sex, we always have done, so we were able to talk about it. I was able to say to him "I'm very upset," and he was very reassuring and saying "No don't worry about it, it doesn't matter." Even after the first couple of times he was saying it doesn't matter when I felt things might never get better, they might remain sort of pretty grotty. He was very reassuring and very loving so I'm very lucky in that way. It's obviously important if somebody is in a relationship for them to talk to their other half about it.

 
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She describes how sex has been different after her hysterectomy and external radiotherapy.

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Age at interview: 35
Sex: Female
Age at diagnosis: 34
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It's certainly not the same now as it was before. You can relax but not fully relax because its quite painful. It can be quite painful because it is on average, apparently I've been told, I didn't know, but apparently the average size of the vagina can vary between six and ten centimetres. And its like the inner tube of a bicycle tyre and it stretches, but if I've got two centimetres less than what I would have had before then yes I notice a difference. So we have to be a little bit more careful. And yeah it can be quite painful. I mean the doctor, the surgeon did say to me that it could be painful forever more and that's probably what's happened to me actually but as long as you're careful, you can still, you can still carry on. Its just not what it was before, its not the same because you can't totally relax and forget that its never happened. 

Some women restarted their sex life quickly after treatment to ensure that all was well. Others waited between six months and in a few cases a year. A few said they had a temporary loss of interest in sex at first which eventually returned to normal.

A few experienced some initial difficulty rebuilding their sex life because their vagina felt narrower and was smaller but these difficulties had been overcome. One woman explained how her partner had a period of impotence for a brief period because he was worried about hurting her which returned to normal after seeing a counsellor.

 

She experienced difficulties rebuilding her sex life after radio-chemotherapy before it was...

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Age at interview: 31
Sex: Female
Age at diagnosis: 30
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So we were really, really nervous at the time because I was afraid that it was going to bepainful. He was afraid and he was like, like the first time you have sex you got all nervous and I could feel that my vagina was a bit shrunk, it was different. And he could feel it as well but it was not painful. But we could feel that it was bit tight, it was not like before. And it was difficult because, it was just difficult because it was not the same. It was different, the vagina was tight and, and the cancer was there, so it was like, it was difficult for him and it was difficult for me and for a while we just decided not to try anymore so I went back to dilators. And I think there was a point, there was a problem with our relationship. I wanted to have sex because I wanted to prove that I was able to do it. And he didn't want sex because he knew it was not right. And he was afraid to hurt me. And then we had a talk and we say 'We can't carry on like this, we have to try because I need it, you need it and we just have to carry on as normal otherwise its going to be another problem.' So slowly, slowly we started with our sex life. But there was like I was always asking 'How is it?' 'Do you think anything was different?' 'Was it different?' 'Do you think its still very tight, my vagina?' And it was, sometimes he didn't tell me the truth and I knew he was lying so I got upset with him. And sometimes because he knew that if he didn't tell me the truth I was going to be upset. He did tell me the truth, and then I was upset because he told me the truth. You know it was like, it was a very, very, very difficult time to rebuild our sex life. I think because instead of waiting four weeks I had to wait all these months it gets more strange doesn't it, to go back. But now it's fine, no problems, the size of my vagina went back to normal and no problems at all. The doctor told me that a lot of women they lose their libido, they don't feel like having sex but I didn't, I felt like before. So nothing change, it's still the same. 

 

Explains that she experienced some temporary difficulties rebuilding her sex life after her...

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Age at interview: 53
Sex: Female
Age at diagnosis: 51
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When we first tried to make love again which was probably about three months after I had the operation and it was very difficult, I was very dry and small, but yes, yes I felt very upset about that. I felt that my sexual being was no longer there. Because I'm fortunate enough to have somebody who's very gentle and understanding and we, we persevered I suppose. Because my immediate reaction was to think oh well no point then is there but we felt that we should try again and once things started to become more normal and we were able to start making love more regularly and it started to feel more normal then that was fine. It was a big relief to me.

I suppose I was sort of hoping that it would be almost back to normal immediately and it wasn't. It took a little while and then everything was fine. Because I think it was the nurse when I talked to somebody about it, the nurse about it, she said that the vagina does stretch and it will stretch and everything will feel okay again. And indeed that was the case.

Several women did not feel any different about their sexuality after their treatment. One woman described feeling less attractive for a while after her hysterectomy because of the physical side effects she experienced. Another who had recent treatment said she found it difficult to feel sexual after all the examinations and treatment she had had. A third had thought other people might believe she had been promiscuous which had initially affected how she felt about herself sexually but these feelings had soon passed.

 

Her feelings of sexuality were not changed by having a trachelectomy.

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Age at interview: 39
Sex: Female
Age at diagnosis: 31
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I think the cervix being an internal organ it doesn't have such a role for me. I can imagine People with breast cancer it's a more physically noticeable part of you if you have to have a mastectomy but the cervix it's invisible really isn't it, it's something you don't see. So people don't look at you differently because they can't see that your cervix has gone so it wasn't a problem for me.

 

Explains how she feels different sexually four months after radio-chemotherapy.

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Age at interview: 28
Sex: Female
Age at diagnosis: 27
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I mean you have to just I have not been able, I have not been able to have sex yet since. And I think a lot of it is to do with the fact that after you've been through this treatment you've been prodded and poked so many times around in your nether regions that actually the prospect of somebody coming any near you wanting to have sex is so repellent. Because you feel like, you feel a bit like a thing I thing and doctors would never want you to say that you feel like a thing but you do because you've had months of people operating on you and you've had about 20 different doctors seeing your bits as you're sort of lying there and you just don't feel very sexy about things like that any more. 

Infertility is a side effect of some treatments given for cervical cancer and can affect how women see themselves. Several said they did not feel any less of a woman but some younger women described feeling less appealing because they could no longer have children. Others who had treatment several years ago commented that these types of feelings had gone away over time. One older woman whose radiotherapy had caused her to have a premature menopause explained said that she had initially felt less womanly after her treatment.

 

Describes how losing her fertility because of her hysterectomy has led to her feeling less of a...

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Age at interview: 34
Sex: Female
Age at diagnosis: 32
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They do say that some women don't feel like women anymore after having a hysterectomy. It didn't enter my head at the time, it really didn't. It has done since. It doesn't make me feel less like a lady, or like dressing up and putting make-up on and things like that, but in the sense that no other man would ever want me if my relationship didn't work out because I can't have children, then that makes me less of a woman and Iwouldn't feel I had anything to offer to a man at all. So my self confidence in that sense has gone but that has been a progressive thing, it wasn't there at the beginning.

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Last reviewed July 2017.

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