Female Pelvic/Genital Cancer

• If the vagina has been shortened due to radical hysterectomy, penile thrusting may be uncomfortable. Changing the angle of penile thrust can be done by elevating your hips on 1 or 2 pillows.
• A deeper, longer vaginal space can be imitated by enclosing the penis within one or both palms. Vaginal lubricants make this more comfortable for the man.
• Some couples find that penetration from behind, as the woman lies on her stomach with her thighs close together can increase pleasure for both.
• If an indwelling catheter is in place, you can place it up toward the abdomen and tape it there to prevent it from being pulled out.
• Vaginal lubricants purchased over the counter can be used to increase comfort during foreplay and intercourse, especially after radiation treatment. See examples under Colorectal Cancer: If an ostomy has been placed.
• If you have received radiation therapy, the vagina may feel tender during treatment and then some scarring may take place. A vaginal lubricant will most likely always have to be used because of damage that radiation may cause to the lubrication glands. During intercourse, the "female on top" position can be used to give a woman more control. Because tight scar tissue normally occurs, vaginal dilators (a plastic tube used to stretch the vagina) must be used 2 or 3 times per week for 10-15 minutes each time to keep the vagina open. It is best if this is done for at least three years unless you are sexually active. You may also use the dilator if intercourse is not possible due to fatigue or if too uncomfortable for you immediately after radiation treatment is finished. The size of the dilator given to you is in no way a reflection of how "well-endowed" your partner is.
• If vaginal reconstruction is necessary, you should be aware of some specific information about your sexual activity and choices other than vaginal intercourse before surgery. This includes self or couple masturbation, oral-genital sex, anal love-play, fantasy options (erotic movies and magazines); routine nudity, cuddling and general pleasuring. If you no longer have feeling in the vaginal area because of the surgery, you can stimulate other areas like the breasts, buttocks, inner thighs, and neck. Taking a bubble bath together with your partner can be soothing to both of you. Please use caution when placing your CD player for soft music and when bringing in your glass of wine. Candles also add a nice touch.
• You can try Kegel exercises to try to prevent painful vaginal spasms by strengthening the muscles in the area between your vagina and anus. Kegel exercises involve tightening and relaxing the muscles of your vaginal area several times a day. This is like trying to hold your urine when you have a full bladder (tightening) and then letting go and urinating (relaxing). You can do this while driving a car or sitting at your desk.
• It is always best to consult with your doctor before resuming sexual intercourse after GYN surgery to ensure that healing has taken place (this can take up to three months).