Sexual desire, function and fertility are significantly affected during radiotherapy. The incidence of sexual dysfunction varies considerably in studies, and it is notably difficult to distinguish the causative factors.The cause of sexual dysfunction is likely to be multifactorial with radiotherapy or adjuvant therapies, disease, social and cultural factors and other symptoms affecting the individual.30
Women treated with radiotherapy for gynaecological cancers may experience changes in the vaginal canal and ovaries, which may lead to effects such as:30
- decrease in vaginal lubrication and sensation
- narrowing and lack of elasticity in the vaginal canal
- cessation of ovulation
- pain during intercourse
- post-coital bleeding.
Vaginal stenosis and adhesion may be prevented using a vaginal dilator and douche as part of sexual rehabilitation after gynaecological radiotherapy. The use of lubrication for a dry vagina reduces irritation and pain, and different positioning may reduce the discomfort associated with decreased elasticity and scarring.30
Men receiving treatment for genitourinary cancers may experience:30
- reduction in libido
- erectile dysfunction
- cessation of sperm production
- pain on ejaculation
- permanent decrease in semen volume.
Assessment of risk and appropriate referral for sexual counselling is an essential element of the role of the nurse in the radiotherapy department.30
Starting the conversation: supporting sexual wellbeing for women with breast cancer76
The psychosexual care of women affected by gynaecological cancers (or PSGC) website77.
Sexuality, intimacy and cancer: a guide for people with cancer, their families and friends78
Resource Document - Management of Radiation Induced Vaginal Stenosis, eviQ. 2012
Reflect on previous discussions about sexual effects of treatment with people affected by cancer, and:
- Discuss barriers and enablers to the process
- Outline evidence based strategies recommended to improve communication about sexuality with people affected by cancer.
Identify resources and referral pathways for a person at risk of sexual dysfunction in your health facility.