The treatments for cervical cancer may affect your sex life, but many of these effects can be prevented or treated.

If you have had a hysterectomy and your ovaries have also been removed, or if you have had radiotherapy to the pelvis, you will have an early menopause (if you have not yet had the menopause). The symptoms of the menopause can include:

• hot flushes
• dry skin
• dryness of the vagina
• feeling low or anxious
• being less interested in sex for a time.

Many of these effects can be eased by hormone creams, skin patches or tablets, prescribed by your doctor. These replace the hormones that are normally produced by the ovaries.

If dryness of the vagina is a problem, your doctor can prescribe creams or you can buy lubricating gels such as KY Jelly, Sylk® or Vielle®  from the chemist. You or your partner can apply them directly to the penis or vagina before or during sex.

Radiotherapy to the pelvis can make the vagina become narrower and this can make sex difficult or uncomfortable. The key to overcoming this problem is to keep the muscles in the vagina as supple as possible. Hormone creams applied to the vagina can help, and are available on prescription from your doctor. Using vaginal dilators or having regular penetrative sex are often the best ways to keep the vagina supple.

Vaginal dilators are usually made of plastic and your nurses or doctor can give a set to you. (Dilators usually come in sets of graduated sizes). A dilator needs to be gently and regularly inserted into the vagina to stretch it gradually and prevent narrowing. The nurses or your doctor can show you how to use the dilators and can answer any questions. They are very used to discussing these issues, so you don’t need to feel embarrassed. Many women find dilators very useful in improving the suppleness of the vagina after radiotherapy, even if they have a regular sexual partner. Dilators can also be useful for women who may have temporarily lost interest in sex due to menopausal symptoms, or who feel nervous about having sex soon after treatment, or who do not have a regular sexual partner.

Many women feel nervous about having sex soon after treatment for cancer, but it is perfectly safe. Sex won’t make the cancer come back and your partner can’t catch cancer from you. Women often find that they need to take more time over sex to help the vagina relax. It may also be easier if your partner is gentle at first so that the vagina can stretch slowly. Regular gentle sex will help the vagina become more supple again and you should be able to go back to your usual sex life a few weeks after the radiotherapy.

If sex is difficult, you and your partner might find it helps to discuss things with one of your treatment team. Although it might feel embarrassing at first, it can really help to talk things through. Your nurse or doctor will have experience in this area and can advise you about what might help. You can also talk to the nurses at Cancerbackup.

Our section on sexuality and cancer has further information and advice.

Pelvic radiotherapy will stop you from being able to have children. This can feel devastating. Infertility is very hard to come to terms with, especially if you were planning to have children in the future or to have more children to complete your family. The sense of loss can be very painful and distressing for people of all ages. Sometimes it can feel as though you have actually lost a part of yourself. You may feel less feminine because you can't have children.

People react differently to the risk of infertility. Some women may come to terms with it more quickly and feel that dealing with the cancer is more important. Others may find that they accept the news calmly when they start treatment, and find that they don't feel the full impact until the treatment is over and they are sorting out their lives again.

There is no right or wrong way to react. Your partner will also need special consideration in any discussions about fertility and future plans. You may both need to speak to a professional counsellor or therapist specialising in fertility problems. They can help you to come to terms with your situation.

Your doctor may be able to refer you to a specialist. The nurses at Cancerbackup can discuss problems you may have and they can also help you to find a counsellor who can offer you help and advice.