Loss of interest in sex is a common result both of being unwell and of the effects of treatment, which may cause tiredness and weakness.  Although you may not feel able to have sex there is still a need, perhaps more so than ever, for an expression of support and love.  You may feel unable to offer much but will appreciate the closeness of others, of being touched, held and cuddled.

If you have had radiotherapy to the vagina and to the cervix this may result in scar tissue, with reduced elasticity.  Radiotherapy may also affect the production of the natural secretions, which will make the area more dry than usual and may make intercourse difficult and painful, especially if it is not attempted for some time after treatment.

One way of overcoming this is to make love gently as soon as possible after treatment (about four weeks).  Having intercourse at this stage helps to keep the tissues stretched and does not allow the vagina to become too tight.  Some women and their partners prefer to wait or find it difficult to resume normal sexual activity.  In this case it is possible to keep the vaginal tissues flexible by using vaginal dilators.  This is a more clinical approach to maintaining the vaginal tissue and therefore does not detract from the fun of lovemaking.  The use of dilators does not affect the ability to achieve orgasm although at first it may not be as strong as before treatment.  For this reason some women find the use of a vibrator helpful.

Following surgery or radiotherapy use a vaginal moisturiser regularly to maintain the elasticity of the vagina or a lubricant during intercourse.  The use of a vaginal lubricant is advised, at least for the first few times you make love.

To reduce the anxiety of anticipated pain and discomfort you may want to change your position during intercourse, so that there is less pressure on the tender areas.  You may find it helpful to take the dominant position, above your partner or lying sideways so that you can control the depth of penetration into the vagina.

Everyone has a sexual identity and sexual needs.  Their importance in our lives may vary greatly from person to person and according to what is happening in our lives.  These needs and feelings are normal and exist regardless of age or whether or not you have a partner at the time of treatment.

On completion of your treatment you may have mixed emotions and concerns about resuming sexual activity.  This is normal and understandable.  If you need to discuss your concerns please contact the Gynaecological Nurse Specialist who will make you an appointment for a private consultation.  All appointments will be private and confidential.

The Gynaecologist Nurse Specialist also has information on lubricants, dilators and vibrators and can advise you on their use.  Please ask your Consultant for further advice or telephone your Gynaecologist Nurse Specialist for an appointment.

Nursing on the ward and in day care, Radiographers in radiotherapy Community Oncology Nurses and/or Macmillan Nurses as well as your own Doctor and District Nurses, who will be kept informed of your care and treatment.