Gynecological Cancer and Pelvic Health Side Effects

Treatment for gynecologic cancer can bring many changes, some expected, others less openly discussed.

After treatment ends, it’s common to notice new challenges with sexual health, bladder control, or bowel function. These side effects may feel overwhelming or isolating, but they are both common and treatable, and you don’t have to face them alone.

In this blog post, we’ll explore how gynecologic cancer treatments such as surgery, radiation, chemotherapy, and hormone therapy can affect pelvic floor function. We’ll also share how pelvic floor physical therapy can help address these side effects, support healing, and restore confidence in your body.

How Cancer Treatments Affect the Pelvic Floor

The pelvic floor is a group of muscles and tissues that support your bladder, bowel, and reproductive organs. It plays a vital role in sexual function, continence, and overall well-being. Treatments like surgery, radiation, chemotherapy, and hormone therapy can directly impact the pelvic floor and surrounding structures.

• Surgery: Procedures such as hysterectomy or removal of reproductive organs may cause scar tissue, weakness, or tightness in the pelvic floor, leading to pelvic pain, bladder leakage, or bowel changes.

• Radiation: Radiation near the pelvis can lead to vaginal dryness, thinning of tissues, scarring, and changes in elasticity. This may cause pain with sex and reduced bladder or bowel control.

• Chemotherapy & Hormone Therapy: Both can lower estrogen levels, leading to vaginal atrophy, dryness, or itching. These hormonal changes can also affect the pelvic muscles and contribute to urinary urgency, leakage, or recurrent UTIs.

• Stress & Tension: The physical and emotional toll of treatment can cause the pelvic floor to tighten and hold tension, resulting in pain, constipation, or difficulty relaxing during intimacy.

Common Side Effects You May Experience

While every journey is unique, here are some of the sexual, bladder, bowel, and pelvic health changes you may notice after gynecologic cancer treatment:

• Sexual Health After Cancer

  • Pain with sex (at the vaginal entrance or deeper with penetration)

  • Vaginal dryness, burning, or itching

  • Loss of sensation or difficulty with orgasm

  • Changes in desire and intimacy due to physical or emotional shifts

• Bladder Problems After Cancer

  • Urinary urgency or frequency

  • Bladder leakage (incontinence)

  • Burning or discomfort with urination

  • Frequent UTIs after sex

• Bowel Problems After Cancer

  • Constipation or straining

  • Loss of bowel control (leakage)

  • Pelvic heaviness or pressure with bowel movements

• Lymphedema

  • Swelling in the legs, groin, and/or lower abdomen can occur when lymph nodes are removed or damaged during surgery or radiation. Lymphedema is a chronic swelling condition that can develop within the months to years after gynecological cancer treatment.

These side effects can affect both your body and your confidence. They are valid, they are real, and they deserve care.

How Pelvic Floor Physical Therapy Can Help

Many of the side effects described above can be minimized and improved through Pelvic Floor Physical Therapy. Working with a pelvic floor physical therapist who has training in oncology care can help restore comfort, strength, and function after gynecologic cancer.

Treatment is always individualized, compassionate, and paced at what feels safe for you. It may included:

• Gentle Internal and External Work: Therapists can help release tension, improve flexibility, and mobilize scar tissue in the pelvic floor muscles.

• Pain Relief and Relaxation: Techniques that reduce burning, irritation, and pain while improving blood flow and tissue healing.

• Strengthening and Coordination: Targeted exercises to rebuild strength, support bladder and bowel function, and improve pelvic control.

• Education for Intimacy: Guidance on positions, use of dilators, lubricants, and sexual health strategies to make intimacy more comfortable and enjoyable.

• Personalized Home Programs: Flexibility and strengthening exercises programs designed specifically for you, empowering you to continue progress at home.

In addition, a Certified Lymphedema Therapist (CLT) plays an important role in both the prevention and treatment of lymphedema after gynecologic cancer treatment. They can provide specialized care and the gold standard treatment of Lymphedema, which includes manual lymphatic drainage, Compression Therapy, and individualized exercise programs to reduce swelling, restore mobility, and improve your quality of life.

Together, pelvic floor physical therapists and certified lymphedema therapists offer a comprehensive approach to addressing the physical side effects of gynecologic cancer treatment, helping you move forward with greater comfort and well-being.

Moving Forward

Healing after gynecologic cancer is not just about survival, it’s about reclaiming your life. Side effects such as sexual health challenges, bladder problems, bowel changes, and lymphedema are common, but they are not something you have to face alone.

Book a free consultation call with one of our Pelvic Floor Physical Therapists or Certified Lymphedema Therapists to learn more about how we can support your healing.

You deserve to feel whole again.