Understanding Radiation Therapy

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Side effects from radiation therapy to the pelvis

If you get radiation therapy to any part of the pelvis, you might have one or more of the digestive problems described in the section “Radiation therapy to the stomach and abdomen.” You may have some irritation of your bladder, as well as changes in your fertility (ability to have children) and your sex life.

Bladder problems

Pelvic radiation can affect the bladder, which can cause problems like:

  • Pain or burning sensations
  • Trouble passing urine
  • Blood in the urine
  • An urge to urinate often

Most bladder problems get better over time, but if the radiation damages the lining of the bladder it can cause radiation cystitis (RAY-dee-A-shun cis-TIE-tis). This can be a long-term problem that causes blood in the urine or pain when passing urine.

In rare cases, radiation can cause abnormal connections called fistulas (FIST-chu-luhs) to form between organs in the pelvis, such as the vagina and the bladder, or the bladder and the rectum. Surgery can be used to fix them.

Radiation treatments for certain cancers, such as prostate and bladder, may lead to urinary incontinence, which means you’re not able to control your urine or have leakage or dribbling. There are different types and degrees of incontinence, but it can be treated. Even if incontinence can’t be corrected completely, it can still be helped. See Managing Incontinence for Men With Cancer to learn more about this side effect and what can be done about it.


Women: Talk to you cancer care team about how radiation may affect your fertility – it’s best to do this before starting treatment. See Fertility and Women With Cancer if you’d like to learn more about this.

Depending on the radiation dose, women getting radiation therapy in the pelvic area may stop having menstrual periods and have other symptoms of menopause. Treatment also can cause vaginal itching, burning, and dryness. Report these symptoms to your cancer care team so you can learn how to relieve these side effects.

Men: Radiation therapy to an area that includes the testicles can reduce both the number of sperm and their ability to function. If you want to father a child in the future and are concerned about reduced fertility, talk to your cancer care team before starting treatment. One option may be to bank your sperm ahead of time. Fertility and Men With Cancer has more information on this.

Other than studies that looked at survivors of atomic bomb blasts, there’s little known about radiation’s effect on the children conceived by men soon after getting radiation therapy. Because of the uncertain risk, doctors often advise men to avoid getting a woman pregnant for some weeks after treatment, especially if the radiation is given to or near the genital area.


With some types of radiation therapy involving the pelvis and/or sex organs, men and women may notice changes in their ability to enjoy sex or a decrease in their level of desire.

Women: During radiation treatment to the pelvis, some women are told not to have sex. Some women may find sex painful. You most likely will be able to have sex within a few weeks after treatment ends, but check with your doctor first. Some types of treatment can have long-term effects, such as scar tissue that could affect the ability of the vagina to stretch during penetration. Again, your cancer care team can offer ways to help if this happens to you. You can also get more information in our booklet Sexuality for the Woman With Cancer.

Men: Radiation may affect the nerves that allow a man to have erections. If erection problems do occur, they are usually gradual, over the course of many months or years. Talk with your doctor about treatment options if this is a concern for you. You can get more information in our booklet Sexuality for the Man With Cancer.

If you get internal radiation therapy with seed implants, check with your cancer care team about safety precautions during sex.

Last Medical Review: 06/30/2015
Last Revised: 06/30/2015