Painful sex is known as dyspareunia. It is a common problem that can be created or made worse after cervical cancer treatment.
We hope this information about what can cause painful sex and ways to manage it is helpful. If you have a partner, you may find it helpful to read this page together or separately.
On this page:
- Causes of painful sex >
- Lubrication >
- Dilators >
- Pelvic floor exercises >
- Different sex positions >
- Psychosexual therapy >
- Getting support from healthcare professionals >
Causes of painful sex
Painful sex is a common problem for many women and people with a cervix, whether or not they have had a cervical cancer diagnosis. However, it can be a problem that is created or made worse after cervical cancer treatment.
Physical impacts of cervical cancer treatment
Surgery and radiotherapy or brachytherapy can both cause hormonal and vaginal changes. This may make the vagina narrower and shorter, which is called vaginal stenosis. Or the vagina may become dryer and less stretchy than it was before, which is called vaginal atrophy.
If you have had surgery to remove all or part of the cervix, the womb and the upper part of the vagina, this may also have changed the physical sensations in your genitals.
Understandably, these changes can make intimacy and particularly penetrative sex more difficult, uncomfortable and painful.
Psychological impacts of cervical cancer treatment
Treatment can also affect how you feel about your body and sexuality, which can make sex less appealing. This could cause sex to be painful if it makes it difficult to become aroused.
If sex you’ve had has been painful, or you are worried it will be, that fear can have a knock-on effect on other areas of your sex life. It could make it harder to feel relaxed or in the moment, which can result in involuntary spasms of your pelvic floor muscles (vaginismus). This tension can then make any pain worse. All of this can create a cycle of distressing, uncomfortable and unsatisfying sex – or it may put you off trying to have sex at all.
The good news is that there are ways to break this cycle and have a sex life that works for you. As well as the information on this page, you may find it helpful to read our information about other sexual problems:
- Read about sex drive after cervical cancer >
- Read about arousal after cervical cancer >
- Read about orgasm after cervical cancer >
Lubrication
Difficulty getting aroused and reduced vaginal lubrication are a common cause of painful or uncomfortable sex. You could start out by using a lubricant and focusing on the intimacy tips that could help sex or masturbation to feel more comfortable.
There are different types of lubricant available. You might want to try out a few different options to see what works and feels best for you and, if you have one, a partner.
As a general rule, it’s a good idea to avoid lubes with lots of chemicals like perfumes or flavourings. These can irritate your already sensitive vagina and make the skin feel sticky or tacky instead of smooth and moist.
Water-based lubricants
Water-based lubricants are the most common types of lubricant. They usually don’t cause as many side effects as some other types of lubricant. They are also safe to use with condoms and dental dams.
Water-based lubricants don’t last as long as silicone or oil-based lubes, so may need to be reapplied frequently. They cannot be used in water, so be careful not to use them in the bath or shower.
Silicone lubricants
Silicone lubricants can be used in water and don’t need to be reapplied as often as water-based types. They are safe to use with condoms and dental dams.
It is best to avoid using silicone lubricant if you are using silicone sex toys, as they can break down the rubber over time.
Oil-based lubricants
Oil-based lubricants last longer than water-based types, but cannot be used with condoms or dental dams. Your healthcare team may suggest you avoid using oil-based lubricant, as they don’t hydrate the vaginal tissue and can cause irritation.
If oil-based lubricant doesn’t cause irritation, you may find it helpful to apply it and then apply a water-based lubricant over the top. This can give a slide and glide sensation, which may help to make sex feel more comfortable.
Getting lubricant
You should be able to get water-based lubrication for free by prescription. Explain your situation to your GP – it can help to include that the painful sex is a result of cervical cancer treatment.
If you would prefer to buy lubricant yourself, there are lots of different options available that can be ordered discreetly and conveniently online. Some companies even offer samples, so you can try before you buy.
HRT and vaginal moisturisers
For hormonal issues related to going through early menopause, your GP may able to prescribe hormone replacement therapy (HRT) or a local oestrogen. You apply these to the vagina as a cream or gel and they help to reduce symptoms like vaginal dryness. Alternatively, you may be treated using vaginal moisturisers. These are usually applied two to three times a week and help keep the vagina moist.
Only using lubricant might not solve the problem, but remember there are treatments and therapies you can try as well. The best solution for you will depend on the exact cause of the problem, which is why it’s important to speak to your GP or healthcare team.