Sexual health and colorectal cancer

How to manage vaginal stenosis, atrophy, and irritation

Vaginal stenosis, atrophy, and irritation can occur as side effects of surgery, radiation therapy, hormone therapy, chemotherapy, and other medications. Be sure to talk with a doctor before colorectal cancer treatment about what to expect and how to manage side effects. Common treatments for vaginal stenosis, atrophy, and irritation include:

Vaginal dilation therapy

Gently stretch the vaginal walls by regularly using a device called a vaginal dilator. Speak with your healthcare provider before treatment begins.

Increase moisture

Vaginal stenosis often results in increased dryness in the vagina, so using a dedicated vaginal moisturizer could help to increase hydration. In addition to vaginal moisturizer, topical estrogen can be helpful. Talk to your doctor about what would work best for you.

Relieve pain

If you’ve experienced any pain during attempted penetration, using a heat pack can reduce discomfort. A feminine cooling pad can be used hot or cold and tucked in your underwear for direct contact.

Pelvic floor therapy

Pelvic floor muscles may be affected permanently after surgery and/or radiation. Pelvic floor therapy reconditions pelvic floor muscles and can reduce pain.

What men need to know about sexual function and colorectal cancer

Men who undergo surgery or radiation for colorectal cancer may develop erectile dysfunction (ED) as a result. Surgery to remove tumors from the colon or rectum often damage nerves. Radiation may damage nerves in your pelvic area, block blood flow to your penis, or decrease the level of testosterone in your body.

Men who smoke or who have a history of heart disease, high blood pressure, or diabetes also may be at a higher risk of ED after radiation therapy. These conditions may have already caused some artery damage, which can be made worse by radiation. Radiation's side effects start slowly. They typically emerge about six months to a year after treatment.

The amount of semen you ejaculate may decrease after radiation therapy. After treatment, you may feel pain during ejaculation after treatment, though the pain usually goes away over time.

Nerves damaged during surgery may cause you to experience a dry orgasm. During a dry orgasm, semen may not leave your testicles or they may be pushed into your bladder (retrograde ejaculation).

How to prevent ED

Your doctor can provide more information about sexual dysfunction. Discuss treatment options, including medications, implants, or devices that can facilitate an erection.

Radiation specialists have developed techniques that target just the rectum and avoid surrounding tissue, nerves, and blood vessels essential to erectile function. Men diagnosed with young-onset colorectal cancer surgery may be candidates for nerve-sparing surgery. This technique causes little or no damage to those critical nerves needed to achieve an erection.

Having open communication with your partner can also help. Let your partner know what works best for you. Be honest about your concerns and feelings. If you're silent about what you're experiencing, your partner may feel rejected. Your partner can offer vital support as you recover from cancer treatment.

A psychologist

A psychologist with a specialization in sexual rehabilitation counseling can provide essential support and guidance to men, women, and couples dealing with sexual dysfunction during and following colorectal cancer treatment. They can help address emotional and psychological challenges, provide strategies to improve communication, and offer techniques to rebuild intimacy and sexual confidence.

A gynecologist (women)

A gynecologist with a focus on female sexual health can offer expert medical advice and treatments for physical challenges related to sexual dysfunction. They can assess the impact of colorectal cancer treatment on sexual organs and function, recommend appropriate interventions, and provide ongoing care to optimize sexual health.

A urologist (men)

A urologist with expertise in male sexual health is a specialist in the anatomy and physiology of the male reproductive system and can provide comprehensive information about the causes of sexual dysfunction. They can recommend targeted treatments and interventions that address the specific issues contributing to sexual dysfunction, helping men regain sexual function, confidence, and overall well-being.

An endocrinologist

Hormonal changes can significantly affect sexual function. An endocrinologist who focuses on hormonal changes can assess and monitor hormonal levels, recommend appropriate hormonal therapies, and manage any side effects to help improve sexual function and overall well-being.

A mental health provider

A mental health professional with expertise in cancer or sexual and relationship issues can offer crucial support in coping with the physical and emotional challenges that cancer brings, and help determine how to move forward in relationships. Whether you have a partner or are looking for one, a therapist with expertise in cancer and/or sexual and relationship issues can provide tailored strategies to manage stress, anxiety, and relationship challenges.

A physical medicine and rehabilitation specialist

Consulting a physical medicine and rehabilitation specialist can promote healing, reduce pain, and improve quality of life. They can provide personalized exercise and rehabilitation programs to enhance physical strength, mobility, and function, which are essential for a healthy sexual life.