Female Pelvic/Genital Cancer

Cancers of the genital (uterus, cervix, vagina, ovary) organs can be especially troubling to your sexuality. If you cannot be physically sexual, this can seriously challenge your sense of femininity and question the image you have of your body. If cancer treatment affects the structure and/or nerves that involve your clitoris or vagina, cervix or uterus, or if your ovaries must be removed, your sexual response cycle may be changed. This type of cancer can cause a great deal of fear and dread. You may have the following thoughts: 1) your life is threatened, 2) you may be concerned about what your outside surface will look like, 3) you may worry whether you will be able to have intercourse and if it will be painful for you, 4) you may fear the loss of fertility, vitality and your ability to have an orgasm, 5) you may fear a decreased libido (sexual desire) or the loss of vaginal lubrication, 6) and you may fear physical aging. These are very normal fears, and there are several suggestions that may help you cope; you can read about them in the Manage section.

It is very important that you have a good deal of knowledge about the treatment that your physician is proposing if you have gynecological (GYN) cancer. You may need only a hysterectomy (removal of the uterus, cervix and ovaries) or you may need more extensive surgery such as a pelvic exenteration (ex-on-er-a-tion). This means that the surgeon will remove your uterus, cervix, ovaries, part or all of the vagina, and your entire bowel and/or bladder. This will create more sexuality issues, not to mention a much longer recovery time from surgery.

If you have cancer of the vulva (the area between the pubic area of the vagina and the rectum), you may need to have your entire vulva removed and reconstruction (surgical repair) may need to be done. When surgery is extensive, you may loose your libido (desire), along with your ability to have an orgasm, and other pleasures can also be reduced. Alternative options to sexual intercourse may need to be explored such as nudity, cuddling and general pleasuring, self-stimulation or masturbation with your partner, oral-genital relations, anal love play, and/or fantasy. This type of surgery (either vulvectomy or exenteration) and reconstruction can feel very devastating and many women say that even when it is explained, they do not feel fully prepared and that reconstruction is not what they thought it would be. You will feel more confident if you have asked your physician all of your questions, and if you can speak to other women who have gone through this type of surgery. Ask your physician, nurse, or social worker to help you get in touch with other women who have undergone extensive surgery like this, or contact your local American Cancer Society who will often have volunteers willing to share their experiences.