I had a hysterectomy almost 2 years ago (2 years in August) due to uterine cancer. I had both ovaries removed and my cervix. I had radiation and chemotherapy, and everything went well. About a year ago, I moved to a new state and started seeing a new gyn/onc. I like my doctor, except for one problem. My vaginal exams are so painful!
I'm very small - I'm a virgin (yes, a 40 year old virgin) and the opening to my vagina is very narrow. My radiation doctor recommended that I get a set of dilators and use them after I had radiation, and I used them for a while, but it never seemed to make that much difference. (He told me it was just to keep me from closing up entirely, which doesn't seem to be a problem, not to "stretch" myself out.) And it is really a pain to have to do this constantly. It's hard to find a dilator that's the right size - the smallest one is barely bigger than a pencil, and it goes in with no problem at all, but the second smallest one is much larger, and it's almost impossible to insert it even a tiny bit without agonizing pain. It's very hard to find anything (whether it's a dilator or a vibrator - which are cheaper and easier to find) that's small enough to fit but large enough to stretch me out.
I told my doctor about the pain during my exam, but he just said he had to get in there to see and he couldn't help it. He said it had nothing to do with the cancer or the hysterectomy - it was just that I was so small. The pain was so bad at my last appointment that I actually bent a metal lamp - I was grabbing onto it, trying not to scream, and I bent it in half. I don't remember having this problem with my other doctor, but I was having so many other issues and pain from the cancer treatment that maybe it didn't seem so bad.
I don't know whether this is a doctor problem, and I should find a new doctor, or whether it's just something I have to deal with. I guess I should be more diligent about the dilators, but it's so unpleasant and painful that I don't use them as often as I should. I've hardly ever read anything on the site about dilators - does anyone use them and does anyone have any suggestions?
I have a very old suggestion and it may or may not help. Years ago I worked in GYN and did pelvic exams and was very good helping women with painful exams, esp virgins with painful exams. I have no idea if this would help after radiation. What I had them do was take a warm/hot bath, and insert a finger into the vagina, could be a small finger, but relax, go slow, and when comfortable apply gentle pressure downward for a little stress. Then (or next time) use a bigger finger, later 2 fingers, finally 3, after however many weeks. By then there was usually enough stretch for a comfortable exam with enough lube. Honestly I think the relaxing bath and heat were key. Also sometimes I sent home a plastic speculum to use to try inserting (closed) at home without pain. I'm not sure that you wouldn't possibly still need dilators. Have you checked the Good Vibrations website, they have products that may have different sizes than you've seen, might be worth a look (look at the silicone items, too). I saw women with horrendous exam pain and this technique, basicly a dilation tecnique, almost always worked. Using lots of lube was crucial, too (not in the tub). I saw 40 year old virgins, too. I'm hoping this info helps you as much as it did those other ladies. Your Dr doesn't sound very sympathetic. Hope you see some improvement soon.
I have had a hard time doin the stretch thing too. I think I have finally worked it into my "routine"
I do it in the bathtub, and use the aquaphor healing ointment because it is thick enough not to come off of the dilator in the tub.
I still find it painful, but the more often I do it, the better. ( I do it while I am waiting for the cream rinse to soak in )
One of the most important parts of the post cancer surveillance is a VERy good pelvic exam.
FOr that reason it is extremely important to maintain a vaginal opening, because if it does close off, then you lose one way that they can pick up a recurrence early.
So thats why I do it....
I guess I also figure some day perhaps me and my DH will be able to have sex again.
I was having painful exams , not from radiation damage, but from vaginal atrophy. Someone here suggested I get the doctor to use the smallest speculum they have. We had a good laugh about my being a virgin at the last exam, but at least it did not hurt.
How often are you using it? If its only once-in-a-while it'll be like starting from the very beginning each time. The more often you use it, the easier it becomes. (and less painful)
I ordered mine from a medical place in NY. I can try to find an old post with the contact info for them. The set was for 4 sizes. I currently use the 2 largest (which don't seem very big in comparison). I use the smaller one for 2-3 minutes to stretch things out, then use the larger one for 10 minutes as suggested by the company. It does hurt at first, but after a minute or two it doesn't.
I've learned over the years to not let more than 2 days go by between use, otherwise its more painful.
I've been told that we will only have to use dilators for a few months afterwards because by then everything will be healed enough to stop and not worry about further atrophy. It sounds like everyone is using them for a lot longer than that. I'm curious, what have you ladies been instructed as far as dilators go? I don't have the greatest confidence in my radiation "team."
I was doing quite poorly after radiation and really did not get around to using the dilator for 2-3 months after radiation, not sure if that made a difference, I wonder if I had been more aggressive earlier, if it might have gone better.
How is radiation going??
The deal about the dilators is that if you are having regular intercourse, then you likely do not need the dilators. With some women the dilator seems to prepare them for intercourse and with other women they just seem to find intercourse easier.
Anna, I was told that I could stop using them once I'm sexually active again. I noticed some changes when I recently couldn't use it of 2 weeks (due to a biopsy). A couple years ago I had to go about a month and the difference was very noticeable. It was like starting from the beginning.