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Managing physical changes during cervical cancer

Early menopause

If your ovaries are surgically removed due to cervical cancer, or if they're damaged during treatment with radiotherapy, it will trigger an early menopause (if you haven't already had it). Most women experience the menopause in their early fifties.

The menopause is caused when your ovaries stop producing the hormones, oestrogen and progesterone. This leads to the following symptoms:

These symptoms can be relieved by taking a number of medications that stimulate the production of oestrogen and progesterone. This treatment is known as 'hormone replacement therapy' (HRT).

Narrowing of the vagina

Radiotherapy to treat cervical cancer can often cause your vagina to become narrower. This can make having sex painful or difficult.

There are two main treatment options if you have a narrowed vagina. The first is to apply hormonal cream to your vagina. This should increase moisture within your vagina and make having sex easier.

The second is to use a vaginal dilator, which is a tampon shaped device that's made out of plastic. You insert it into your vagina and it is designed to help make your vagina more supple. It is usually recommended that you insert the dilator for five to ten minutes at a time on a regular basis during the day, over the course of 6 to 12 months.

Many women find discussing the use of a vaginal dilator embarrassing, but it's a standard and well-recognised treatment for narrowing of the vagina. Your specialist cancer nurse or radiographers in the radiotherapy department should be able to give you more information and advice.

You may find that the more times you have sex, the less painful it becomes. However, it may be several months before you feel emotionally ready to be intimate with a sexual partner.

Lymphoedema

If the lymph nodes in your pelvis are removed, it can sometimes disrupt the normal workings of your lymphatic system.

One of the functions of the lymphatic system is to drain away excess fluid from the body's tissue. A disruption can cause a build-up of fluid in the tissue. This can lead to certain body parts becoming swollen, usually the arms and legs. This is known as 'lymphoedema'.

There are a number of exercises and massage techniques that can reduce the swelling. Wearing specially designed bandages and compression garments can also help.

Bladder problems

Bladder sensations or control may change after surgery or radiotherapy. Some women find they need to pass urine more often, or feel that they need to go in a hurry. Others may lose a few drops when they cough, sneeze, strain or lift.

For ways to manage involuntary or accidental loss of urine (urinary incontinence), contact the continence nurse or physiotherapist at your hospital. You can also contact the Continence Foundation of Australia on 1800 330 066.

After radiotherapy, the blood vessels in the bowel and bladder can become more fragile. This can cause blood to appear in your urine or bowel movements, even months or years after treatment. Let your doctor know so the appropriate treatment can be given.

Fertility problems

Treatment for cancer of the cervix may prevent you from being able to bear children.

If fertility is an important issue for you, talk to your doctor before treatment about ways to preserve it. New ways of dealing with infertility are being developed.

Sources: Cancer Australia (Living with cervical cancer), NHS Choices, UK (Cervical cancer)

Last reviewed: October 2015

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