Dear Dr. Myrtle,
I have completed radiotherapy for cervical cancer, but I’ve noticed that my vaginal space isn’t as big or as flexible as it used to be. Is there anything I can do to help recover my previous abilities?
First, I’d like to address the health part of your question. This part of your body has been through a lot, and needs some recuperative attention. This first information really doesn’t have as much to do with "having sex", as it does with helping your body heal again.
Healing Step Number Two
Healing step Number One, of course, was that you had treatment for a serious medical threat. Congratulations! Now that you’ve been through the radiation, your body will naturally scar some to try to heal the damage that was inadvertently done while the radiation was zapping those cancer cells. One way to help to soften the scar tissue (inside and outside) is to massage your skin with a moisturizing lubricant of your choice.
The way to do the massage is to make a plan for yourself. I often suggest that you put the bottle of moisturizer by your toothbrush, so that when you brush your teeth morning and night, you also do your massage morning and night. A reminder: this doesn’t mean that you are "ready, honey!" for sex. If you need to lock your bathroom door, by all means do. This is really a self-care issue.
Put a dime-quarter size dab of lubricant on your fingertips, and massage your entire vulva (the outside of your vaginal area), your clitoris, the vulvar lips ... by using a press-and-release technique, not a friction massage. Your goal is to bring new blood to your skin with these strokes, and to push old blood and fluid out of the skin. You are not trying to stretch your skin; rather, you are trying to increase your skin’s flexibility. You don’t need to feel "wet" when you are done, but do use enough lubricant that your massage feels somewhat slick, so that you know that you are using enough to moisturize.
If you feel comfortable, go ahead and massage the lubricant into the opening of the vaginal canal, using these same circular strokes. Most women find that they can accomplish this in about five minutes, so you don’t need to feel that you’ll be spending the rest of your life doing this. I usually suggest that women who are at your stage of recovery do this massage for about two weeks before progressing to the next step.
If you forget an evening, or go away for a weekend - don’t worry about it. Your teeth don’t fall out if you don’t brush your teeth once, and your vulva isn’t going to fall off if you forget to do this massage. Just get back to your routine when you are ready or able to do so.
Healing Step Number Three
The next step is to use a smooth-surfaced vibrator (something that can be inserted into the vagina) to help slowly and comfortably massage your inner vaginal skin, and help you massage lubricant far up into your vagina. We recommend using one of the Vaginal Renewal Massage Wands for this part of the process. You can start by just coating the wand with lubricant and inserting it as far as is comfortable. If you've had radiation, you may be instructed to push it firmly as far as it can go, so that you break up the developing scar tissue before it gets too thick. You can then turn on the vibrator to a vibration level that feels comfortable, and let it run in place for 5 - 10 minutes.
You’ll want to find out what size will work best for you at this point in your recovery. The best way to tell which size to get is to see how many fingers you’re comfortable being penetrated with when you’re not sexually aroused. Once you know this, you can get a wand that is approximately the same width across as your finger(s). Start with one that is right for you now, rather than something you want to "work up to." To know when you're ready to move to a wider wand, you will want to try gently inserting a lubricated finger alongside of the wand. If you can do so comfortably, you're ready for the next size.
Again, the goal here is to bring blood to the area; to exchange blood/lymph fluid; and to increase the flexibility of your skin. (It isn’t that you’re "too tight" - we don’t want flabby vulva lips here! It’s that we are trying for increased flexibility so that your skin can adjust to penetration if you so choose.)
Healing Step Number Four
The next step is to evaluate yourself with regard to your orgasmic potential. Are you able to bring yourself to orgasm currently? (Could you before, or could you ever?) This is important, because I think the radiation may also have an effect on your blood vessels, which can make orgasm more difficult. If you are able to bring yourself to orgasm, you have my prescription to bring yourself to orgasm at least once a week (for the rest of your life). This is really preventive maintenance of your body. If you are not able to orgasm now, or have never been able to orgasm, check out one of our articles on this site about how to learn to orgasm, or pick up a good book on the subject. If you haven’t tried to orgasm since all of this radiation stuff, please attend to your "homework" and find out if you can still have orgasms.
It’s important to continue to have sexual pleasure, because I have met and spoken with many women who say that the *first* thing they thought of was life/death and surviving, and that they de-prioritized this "sexual pleasure" part. Then, as the years roll by, some of that scarring has already occurred, and it’s difficult for some women to experience orgasmic release. It seems to be an easier road to maintain the system/process than to recover it (although recovery is possible too).
The road going forward depends on the process, rather than an endpoint. The path you travel from here may take you to continued daily massages, with intermittent orgasms; or you may find that you can take vacations from the massage/orgasm schedule, and restart the program when you need to. Listen to what your body needs, first and foremost.