How Radiation Therapy Can Affect Sex for Women
Radiation therapy to the pelvis can cause sexual problems for many women with cancer. These problems can be temporary or last long-term after treatment has finished. Radiation to other body parts, such as your breasts, can also interfere with sexual desire.
Learn more about how radiation therapy can affect your sex life and how to get help managing these problems.
Talking with your cancer care team
Don't assume your cancer care team will ask you about sexual problems. Remember, if they don't know you’re having a problem, they can't help you manage it.
- Before you start radiation therapy, ask how it could affect sex for you in the future.
- As you go through treatment and follow-up care, tell them about any changes you have in your sexual life or any new problems that come up.
The information below describes common sexual problems faced by adult women (or people with female reproductive organs*) after certain types of radiation therapy. You might have problems or needs that aren’t addressed here. Your cancer care team can help you manage your specific situation.
*To learn more about the gender terms used here, and how to start the conversation with your cancer care team about gender identity and sexual orientation, see Gender Identity, Sexual Orientation, and Cancer Treatment.
Radiation side effects and sexual desire
Radiation therapy to any part of your body can cause side effects that lower your desire for sex while you experience them.
Pain can make you feel worried, depressed, or easily discouraged which can make it hard for you to get excited about sexual activity. It can also make it hard for you to find a comfortable position for sex.
Other side effects from radiation that can lower your desire for sex include:
- Fatigue
- Nausea and vomiting
- Changes in how you look, such as rashes, hair loss, or changes in one or both of your breasts
- Diarrhea or not being able to control your bowels
- Incontinence (not being able to control your bladder)
How long does this last?
Some side effects, like fatigue and nausea, will likely get better over time. But even if a side effect from radiation is permanent, there are many ways to manage and adapt to these changes and have a fulfilling sex life. Learn more in Managing Sexual Side Effects as a Woman with Cancer.
How pelvic radiation can affect sex
You may get radiation to your pelvis and abdomen (belly) for several different cancers, such as ovarian, uterine, cervical, bladder, colon, and rectal cancer.
Radiation to your pelvis can affect your sex life during and after treatment. This is because the radiation beams damage the tissue in and around female genitals. You can learn more about the side effects of radiation for specific types of cancer in Cancer Types.
But in general, radiation to the pelvis can affect your sex life by causing changes to your vagina, premature menopause, and fertility issues.
Vaginal changes
Pelvic radiation can cause changes to your vagina that make penetrative sexual activities painful or difficult.
Vaginal dryness, soreness, or pain
During radiation, tissues in the treatment area can get irritated. They may become pink and swollen and look sunburned. Your vagina may feel tender during radiation treatment and for a few weeks afterward.
Radiation to your vagina can also damage the lining, making it thin and fragile. You may have some light bleeding after sex, even if you don’t have pain. While it is rare, you may develop vaginal ulcers or open sores. These can take several months to heal after radiation therapy ends.
Vaginal scarring and narrowing
When treatment ends and the irritation heals, you might develop scarring. The walls of your vagina may become less soft and flexible.
Treatment can also shorten or narrow your vagina. This means your vagina might not stretch out as much as before. This can make sex painful and might make penetrative sex impossible.
Premature menopause
Radiation therapy to your pelvis can affect the ability of your ovaries to make female sex hormones. Sometimes this is just for a short time, but with higher doses of radiation, it can be permanent.
If you’ve already gone through menopause: You may see little to no change because your ovaries have already stopped making hormones.
If you haven’t yet gone through menopause: Radiation to your pelvis might cause you to go into menopause before you reach the usual age (premature menopause). You may stop menstruating (having periods) and develop menopausal symptoms like hot flashes and vaginal dryness.
Young women who get smaller doses of pelvic radiation may start to menstruate again as their ovaries heal. But if you get larger doses of radiation therapy, the damage could be permanent.
The loss of sex hormones that comes with menopause can also cause other vaginal symptoms. You might develop:
- A lower sex drive
- Vaginal dryness
- Vulvar and vaginal itching
- Vulvar and vaginal irritation
Fertility issues
Women who get radiation to their pelvis might become infertile. This is more likely to happen if you are older, because the number of eggs in your ovaries decreases over time.
Whether or not you become infertile also depends on the amount of radiation absorbed by your ovaries. High doses might destroy some or all of the eggs in your ovaries, causing infertility and early menopause.
If you would like to have children in the future, fertility preservation might be an option. If you’re interested, talk to your cancer care team before your cancer treatment begins.
Is it safe to have sex while getting pelvic radiation?
Whether it is safe to have sex while getting radiation will depend on the part of your body getting the radiation, the type of radiation, and whether you are fertile (able to conceive a baby).
Preventing pregnancy
Radiation can harm a developing fetus. It is very important to avoid pregnancy while you are getting radiation treatment.
Your cancer care team will likely suggest that you use at least one form of effective birth control. Ask how long you should wait after treatment before having unprotected sex or trying for a pregnancy.
Protecting your partner from radiation
Certain types of radiation can cause your body to release radiation. You may need to take precautions to protect people around you, including sexual partners. Ask your radiation oncology team whether you can be sexually active during treatment or whether you need to wait until they say it’s safe.
Oral or systemic radiation therapies
These types of radiation are most often used in women to treat thyroid and bone cancer. The treatment can travel through your whole body. To protect the people around you, you will need to take radiation precautions for many days.
During this time, you should keep space from other people, which includes avoiding most touching and sexual activity. You will be told how long you need to take precautions.
Radiation implants (brachytherapy)
Radiation implants (brachytherapy) are used to treat certain types of cancer. A radiation source is put inside your uterus or vagina.
- Some implants are left in for hours or days then removed before you go home. Once the implant is taken out, your body no longer gives off radiation, so no precautions are needed.
- Other implants (radioactive seeds or needles) are left in place near your cancer. They are not removed and lose their radiation over time. You will be checked to see whether your body is releasing radiation and whether you need to take precautions.
Depending on the type of implant you receive and how much radiation is being released by your body, you may have to follow radiation precautions for a certain number of days. Most likely, sex will not be allowed while the implant is in place.
External beam radiation therapy
This type of radiation therapy is given by a machine outside your body. The radiation is only on while the treatment lasts. This type of radiation does not leave any radiation to be released by your body. As long as you feel up to it, you should be able to have sex in between treatments.
See Radiation Therapy for information about the different types of radiation and the precautions you may need to take.
What can help with the sexual side effects of pelvic radiation?
There are some therapies and exercises that might help you manage the effects of radiation therapy on your sexual health. Talk to your cancer care team to find out if any of these might be helpful for your situation.
To learn more about physical and emotional problems related to cancer treatment and sexuality, see Managing Sexual Side Effects as a Woman with Cancer.
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
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Last Revised: April 15, 2025
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