Pelvic Radiation Can Affect a Woman’s Sex Life

How pelvic radiation can affect sex

Radiation to the pelvic area often affects a woman’s sex life. If the ovaries get a large radiation dose, they may stop working. Sometimes this is just for a short time, but often it’s permanent.

If a woman has already gone through menopause, she may notice little or no change because her ovaries had already stopped making hormones. But if she hasn’t reached menopause, radiation may cause sudden menopause with hot flashes and vaginal dryness. These are discussed in Treating Sexual Problems for the Woman With Cancer.

Young women who get smaller doses of pelvic radiation may start to menstruate again as their ovaries heal. But with larger doses of radiation therapy, the damage is almost always permanent. Women who get radiation to the pelvis often become infertile. But no matter what the radiation dose, women younger than 50 should talk with their team before stopping birth control since it may be possible to become pregnant.

During radiation, tissues in the treatment area get pink and swollen and may look sunburned. A woman’s vagina may feel tender during radiation treatment and for a few weeks afterward. As the irritation heals, scarring may occur. The thick walls of the vagina may become leathery and tough. This means the walls might not stretch out as much during sex, which can cause pain.

The scarring that can occur after pelvic radiation can shorten or narrow the vagina. A woman can often keep tight scar tissue from forming by stretching the walls of her vagina with vaginal penetration during sex at least 3 or 4 times a week or using a vaginal dilator on a regular basis. (See “Using a vaginal dilator” in Treating Sexual Problems for the Woman With Cancer.)

Radiation to the vagina can also damage its lining, making it thin and fragile. Many women notice some light bleeding after sex, even though they felt no pain at the time. In rare cases, women get ulcers, or open sores, in their vaginas, which may take several months to heal after radiation therapy ends. In some cases, the bladder and bowel are damaged by radiation to this area, and these changes can also impact sexual health.

Can a woman have sex while getting pelvic radiation?

As long as a woman is not bleeding heavily from a tumor in her bladder, rectum, uterus, cervix, or vagina, she can usually have sex during pelvic radiation therapy. The outer genitals and vagina are just as sensitive as before. A woman should be able to reach orgasm, too. But some studies suggest waiting 4 weeks after radiation to let the swelling and inflammation settle down, and to reduce the risk of tearing the tissues.

A woman should follow her cancer care team’s advice about sex during radiation therapy. Radiation therapy from a machine outside the body does not leave any radiation in the body, so your partner will not come in contact with it.

Some women are treated with an implant. An implant is a radiation source put inside the bladder, uterus, or vagina for a few days. Sex may not be allowed while the implant is in place. Women treated with this type of radiation do not transmit radiation after the implant is removed.

See the Radiation Therapy section for information about the different types of radiation and the precautions you may need to take.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: January 12, 2017 Last Revised: January 12, 2017

American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.