Vaginal pain & dryness

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Vaginal pain

Occasional vaginal pain is usually experienced during vaginal manipulation or sexual intercourse. If it becomes more severe then it is mostly associated with an underlying medical and/or psychological condition. The following medical conditions are some of the possible causes of vaginal pain. There are likely to be other causes, so ask your doctor about your symptoms.

  • Vaginal infection - often accompanied by vaginitis, which is an inflammation of the vagina characterized by discharge, odor, irritation, and/or itching.
  • Vaginitis - inflammation of the vagina
  • Atrophic vaginitis - vaginal inflammation due to deterioration of the vaginal walls caused by reduced oestrogen levels. Menopause, surgical ovary removal and childbirth can all be the cause of the decrease in oestrogen levels.
  • Painful intercourse - vagina pain experienced during sexual intercourse is called dispareunia. Dyspareunia can be divided into three types of pain: superficial, vaginal, and deep. Superficial pain is associated with attempted penetration. This is usually caused by changes in anatomy, irritative condition, or vaginismus (vaginal entrance muscle spasm). Vaginal pain is associated with friction, indicating a problem with lubrication and /or arousal disorders. Deep pain is related to thrusting and is indicative of pelvic disease or an inability for pelvic relaxation. Possible causes of painful intercourse include vaginal dryness, vaginal injury, pregnancy, post-childbirth, vaginal or vulva infection, infection of the bladder (cystisis) or urethra (urethritis), breast, cervical, uterine, ovarian or vaginal cancer. Painful intercourse may also be connected to various psychological disorders such as anxiety, depression, loss of libido, vaginismus etc. There may be other possible cause, so ask your doctor about your symptoms.
  • Vaginal cancer - malignant tumour involving the vagina.
  • Radiotherapy - can cause scarring, narrowing and/or dryness of the vagina.

Vaginal Dryness  

Radiotherapy may cause scarring, narrowing and dryness of the vagina. Likewise some drugs such as the aromatase inhibitors for breast cancer can cause vaginal dryness  (letrozole, anastrozole, exemestane) This can make it difficult for your doctor to examine you at follow-up appointments and can make normal sexual intercourse difficult.

To help minimize this problem a dilator kit and lubricating cream may be useful. This kit contains a range of plastic tubes of various sizes which dilate or stretch the vagina. This helps the muscles of the vagina to relax. The kit also contains a cleaning brush that can be used to clean the dilators after use. In postmenopausal women oestrogen creams and pesseries may help but ask your doctor first if this is safe if you have breast cancer. These will help to keep the lining of your vagina moist and supple.

If you have had recent radiotherapy, we recommend that you start using the dilators one to two weeks after the end of all your radiotherapy treatment, as long as any soreness has begun to settle down. The dilators should be used every other day initially and then every third day after six months. Once you are sexually active again the dilators need not be used on the days that you have sexual intercourse. Slight bleeding or spotting may occur during intercourse or after using the dilators during the first few weeks. However, if the bleeding persists or is unduly heavy, do not hesitate to contact your doctors or specialist radiographer.

Using a vaginal dilator

1.Place the lubricating cream on the rounded end of the dilator.

2. Lie on your back with your knees slightly bent or stand with one foot on the bath or on a stool.

3. Insert the dilator gently as far as is comfortable. Withdraw and reinsert the dilator several times for a total of five minutes.

4.Clean the dilator with warm soapy water.

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.

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