What can help with painful sex after pelvic radiation?

Radiation therapy to the pelvis can cause vaginal dryness, narrowing (stenosis), thinning (atrophy), and itching or burning that can make sex uncomfortable or painful. According to the National Cancer Institute, there are several ways a care team can help make sex more comfortable.

Options include:

• vaginal gels or creams to stop a dry, itchy, or burning feeling
• vaginal lubricants or moisturizers
• vaginal estrogen cream, which may be appropriate for some types of cancer
• a dilator to help prevent or reverse scarring, if radiation therapy has affected the vagina
• exercises for the pelvic muscles to lower pain, improve blood flow, and support sexual health

The National Cancer Institute also notes it can help to manage related side effects such as pain and fatigue, and to get support and counseling, including professionally led support groups.

Because the right choice depends on your type of cancer and treatment — for example, vaginal estrogen cream is not suitable for everyone — ask your care team what is appropriate for you. Your doctor, nurse, or a sexual health expert can recommend options and help you feel more comfortable.