Most women experience a temporary decrease in libido (desire). This may be due to tiredness, weakness, a change in how they feel about their appearance, or a general feeling of illness. Remember, sex requires extra energy! It is an individual thing, but it can take several months or more for interest to return.
Radiation and graft-versus-host disease (GVHD) may cause vaginal dryness, vaginal narrowing, inflammation of the vaginal wall, and pain with intercourse. Treatment depends on the cause. Doctors from the Endocrinology and Gynecology teams can advise you about management strategies.
Following treatment, patients may resume sexual relations. Resuming relationships will take patience and time. Communication with your partner is the key. Touching and caressing take much less energy than sexual intercourse and can be just as intimate and satisfying.
Chemotherapy and radiation therapy can affect the ovaries, causing temporary or permanent infertility. Infertility is the inability to have children. While it is uncommon, some women do recover their ovulation after chemotherapy for two or more years post-BMT. This should be kept in mind when engaging in unprotected sexual intercourse. For some women, freezing (cryopreservation) of fertilized eggs (ova), called zygotes, may be possible prior to receiving high-dose therapy. Your BMT physician can discuss this in more detail if you wish.
Women will notice that their menstrual cycle, or period, becomes irregular or stops following chemotherapy or a blood and marrow transplant. If it does not stop, hormone replacement therapy may be started to stop the flow. This decreases the risk of excessive blood loss while your platelet and hemoglobin counts are low. Provera or Ovral are drugs commonly used to stop menstrual flow. Once your counts have recovered enough that blood/platelet transfusions are no longer necessary, these medications can be discontinued. Due to your increased susceptibility to infection, if you do have a period, avoid the use of tampons.
After chemotherapy or blood and marrow transplant, menopausal symptoms can occur due to a lack of ovarian hormone production. Hormones are chemicals made by the body that control many different functions of the body. Menopausal symptoms include hot flashes, vaginal dryness, inflammation of the vaginal wall, pain during intercourse, irritability, and decreased libido (desire).
Hormone replacement therapy such as Premarin or Provera may be used to lessen these symptoms and to prevent bones from becoming weak and brittle, leading to osteoporosis. Some women find that using lubricants, gels or other vaginal creams such as K-Y jelly (Vaseline is not recommended) may help to relieve some of the vaginal discomfort. It is important to discuss these issues with your gynecologist or BMT doctor.
It is important to know that many of the symptoms listed here can be treated. If you have any of these symptoms, talk to your doctor. Don't suffer alone.