Pelvic radiotherapy usually stops the production of sex hormones by the ovaries. Hormone levels generally start to lower over about three months from the start of treatment. Your periods will gradually stop and the symptoms of the menopause may then occur. Your doctor or specialist nurse can talk to you about the likely effects of radiotherapy in your particular case. An early menopause due to radiotherapy can cause more severe menopausal symptoms than a natural menopause. The symptoms will pass but they may take a couple of years. These can include:

• Hot flushes and sweats
• Vaginal dryness
• Passing urine more often
• Lower interest in sex
• Tiredness and difficulty sleeping
• Dry skin
• Aches and pains
• Mood swings, poor concentration, lower confidence and changes in memory.

All of the above effects may affect your sex life in some way.

When you have an early menopause and are no longer producing eggs, you will not be able to become pregnant. It usually takes about three months after the radiotherapy finishes to stop producing eggs. During this time it is important to use effective contraception, but after this time contraception is not needed. If you don’t get menopausal symptoms, a blood test to check your sex hormone levels can show whether the menopause has happened.

You can discuss with your specialist at the hospital whether you can have hormone replacement therapy (HRT). HRT can help to control the menopausal symptoms. If you have had breast cancer or some gynaecological cancers you may need to avoid taking HRT which contains oestrogen. However, you can talk to your doctor about other medicines which can help to control menopausal symptoms, such as low-dose progesterone treatment. Some post-menopausal women also have hot flushes after radiotherapy. Some women find complementary therapies such as evening primrose oil, acupuncture or herbal remedies helpful.

Having low sex hormone levels at a young age can increase the risk of weakening of the bones (osteoporosis) as women get older. Radiotherapy can also directly affect the bones in some women. HRT and other medicines can help the bones to stay stronger.

After pelvic radiotherapy you will not be able to have children due to the effect of radiotherapy on your womb. 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. Sometimes it can feel as though you have actually lost a part of yourself. You may feel less feminine.

Our booklet Relationships, Sex and Fertility discusses the options for having a baby (such as adoption or surrogacy) if treatment has affected your fertility.

People vary in their reactions to 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 the impact doesn't hit them 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 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 fertility specialist or you can be put in touch with one directly by contacting a support organisation. The nurses at Cancerbackup can discuss problems you may have and they can also help you to find a counsellor who can give you help and advice.

We have information on the emotional effects of cancer and its treatment and how to deal with them.