Vaginal changes after radiotherapy
to the pelvis

For women, radiotherapy to the pelvis area can sometimes cause inflammation and scar tissue in the vagina. If this happens, sexual intercourse and medical examinations may be painful or difficult, and in some cases impossible.

What changes may happen?

Inflammation can cause the walls of the vagina to stick together as they heal. When this happens, the vagina can become shorter and more narrow (stenosis). Your vagina may also become dry, sore and less stretchy.

How can I manage vaginal changes?

There are things you can do after your treatment to help keep the vagina open and the tissue soft and flexible. These include:

  • using dilators, fingers, vibrators or other devices
  • having regular sexual intercourse (if you are sexually

These activities may be uncomfortable, but shouldn’t cause pain.

What is a dilator?

  • A vaginal dilator is a smooth plastic tube with a
    rounded end.
  • It is usually about 12-15cm long and comes in
    several sizes ranging from small to large (see
    picture below).

When do I start using a dilator?

The best time to start using a dilator can vary. It is common to start between 2-8 weeks after your radiotherapy treatment has finished, allowing time for healing.

How often should I use the dilator?

Use the dilator as your specialist doctor advises. It is common to use it at least 3 times per week for 5 minutes each time. Continue to use it for as long as your doctor advises. This time frame may vary between different women.

How do I use the dilator?

  • Wash your hands and the dilator in warm soapy water and rinse well before each use.
  • Lie down, or stand with one leg bent supported by a chair, bed, bath or toilet.
  • Place a water based lubricant along the length of the dilator and around the entrance of your vagina before insertion.
  • Examples of lubricants are K-Y Jelly®, Sylk®, Glide® and Wet Stuff®.
  • Don’t use Vaseline or baby oil as some oils can cause irritation.
  • Hold the dilator in one hand and with your other hand spread the lips at the opening of your vagina and gently insert the dilator.
  • Try to relax – some resistance from your pelvic muscles is normal.
  • Once inserted as far as possible, slowly and steadily rotate the dilator.
  • Push gently deeper into the vagina using a circular motion for 5 minutes.
  • When finished, remove the dilator and wash it in warm soapy water, rinse and dry.
  • Store the dilator in a dry place where it will not become scratched or damaged.

Common questions

  • Sexual intercourse will also stretch the vagina.
  • If you are having sexual intercourse regularly (at least 3 times per week) using a dilator may not be necessary.
  • A small amount of bleeding or ‘spotting’ after using a dilator is quite normal.
  • If there is a lot of bleeding or pain after using the dilator, talk to your nurse or doctor.
  • Non-hormonal lubricants may be used and are available from your chemist.
  • Some examples include: Replens®, Aquagel®,
  • Douching, and some creams and perfumed soaps may cause irritation.
  • If you are unsure, ask your doctor or nurse.