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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. We suggest Liquid Silk, because 1) it is a moisturizing water-based lotion, 2) it won't give you a yeast infection, and 3) it will soak into your skin. It also won't get sticky at all, which helps with the massage part, as well as not increasing friction to your skin.
The way to do the massage is to make a plan for yourself. I often suggest that you put the bottle of Liquid Silk 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 small circular strokes. Your goal is to bring blood to your skin with these strokes, and to push lymph and blood 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 dildo (something that can be inserted into the vagina) to help slowly and comfortably stretch out your inner vaginal tissues, and help you massage lubricant far up into your vagina. Many women in your situation like to use a Lucite or glass dildo, since they provide much less friction than silicone dildos. You'll find that you can apply the same massage to the inner surfaces of their vaginas with the dildo once you get the rhythm of the circular strokes on the outside (vulva). It isn't so much that you want to just push the dildo in and out; it's really that you want to think of the dildo as an extension of your hand and hand motions, so that you can begin massaging deep inside of yourself.
Dildos come in all shapes and sizes, so 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 dildo that is approximately the same width across as your finger/fingers. The width is more important than the length, and all our dildos have "finger size" measurements in their descriptions on our site and in our store. You may find that, over time, you're comfortable with a wider width, in which case you can buy a larger dildo. For now, though, buy one that is right for you now, rather than something you want to "work up to".
Again, the thought here is to bring blood to the area; to exchange blood/lymph; 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 though 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).
From Here?
The road from here 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.
Good luck!
Dr. Myrtle
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