Radiation effects on women
There is always the potential for some side effects to occur when radiation therapy is given to the pelvic area. Radiation can affect a woman’s reproductive organs. Changes in reproductive organ function depend on:
- the amount of tissue treated
- the dose of radiation given
- whether chemotherapy drugs are given in addition to radiation therapy
Side effects may occur during or after radiation therapy. Side effects may go away once treatment is over, but some may continue after radiation therapy is finished.
Radiation therapy can cause:
- vaginal dryness, burning or itching
- vaginal narrowing (stenosis) and scarring of the vagina
- fistulas (abnormal openings) between the vagina and the bladder, ureters or rectum, which may cause some leakage of urine or stool through the vagina
Report vaginal symptoms to the radiation therapy team. Water-based vaginal lubricants may be used to relieve vaginal dryness. Sexual intercourse or vaginal dilators can be used to help keep the vagina open.
Radiation therapy can affect ovarian function. The effects depend on the woman’s age and the dose of radiation to the ovaries. Loss of ovarian function can occur 2–3 weeks into treatment. Menstruation may stop and symptoms of menopause may occur in premenopausal women. The loss of ovarian function may be temporary or permanent.
The radiation therapy team will try to shield a woman’s reproductive organs (including the ovaries) from radiation, unless they contain cancer. Women should talk to the radiation therapy team about menopausal symptoms and how to cope with them.
Depending on the woman’s age and the dose of radiation, radiation therapy’s effect on the ovaries can cause fertility problems. Loss of ovarian function can occur 2–3 weeks into treatment. This can result in infertility (inability to become pregnant). The ovaries may stop producing eggs. Sometimes the ovaries will begin to produce eggs again once treatment ends and periods return to normal. If the ovaries don’t recover, infertility will be permanent.
The radiation therapy team will try to shield a woman’s reproductive organs (including the ovaries) from radiation, unless they contain cancer. Occasionally, a surgical procedure may be done to move the ovaries (oophoroplexy) out of the treatment area before radiation is given.
Women can talk to the radiation therapy team about when it is safe to have sex during radiation therapy to the pelvic area or if they need to take any special precautions. Women should avoid becoming pregnant during radiation therapy because of genetic changes that may occur in their eggs. Radiation therapy during pregnancy may harm a developing fetus. Discuss birth control options with your doctor.
Women and their partners may have concerns about future childbearing. Before treatment starts, they should talk to their doctor about the effects radiation treatment may have on their ability to have children and fertility options.
Girls who receive radiation to the pelvis may experience:
- lack of estrogen production
- If the ovaries are affected by radiation, they may not produce female sex hormones.
- A lack of female sex hormones prevents the development of secondary sex changes, such as growth and maturation of the reproductive organs and the appearance of hair in the pubic area and underarms.
- vaginal dryness, burning or itching
- narrowing or scarring of the vagina (vaginal stenosis)
- abnormal opening (fistula) between the bladder and vagina, or between the rectum and vagina, which may cause some leakage of urine or stool through the vagina
- infertility – if the ovaries are exposed to high doses of radiation therapy
- early menopause (by the age of 30) – if the ovaries have been damaged and don’t function properly
Every effort is made to shield the ovaries from radiation, if possible. Other female reproductive organs cannot be shielded. Symptoms such as vaginal dryness should be reported to the radiation therapy team.