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Survivorship Guide for Bone Marrow/Stem Cell Transplant
Coping with Late Effects

Vaginal Concerns

Many women report vaginal dryness, skin irritation, and pain with intercourse following transplant. The vaginal skin may be more prone to inflammation and tearing from many factors. Low estrogen levels due to premature menopause can cause drying and thinning of the vaginal lining. Radiation treatments to the pelvic area and GVHD can have the same effect and can also lead to vaginal stenosis, a condition where the vaginal opening becomes narrower, shorter, and less flexible. Vaginal stenosis can make intercourse and clinical examinations more painful or impossible. Regular intercourse and vaginal dilators can help prevent and in some cases treat vaginal stenosis. Women should see their gynecologist if they develop pain with intercourse so that they can be treated early before the condition progresses. Topical estrogen or immunosuppressive creams may also be helpful. If vaginal adhesions form, surgery may be required.

Inflammation of the genital area can also be caused by a skin condition called lichen planus, which can result in itchy, painful lesions. Although there is no cure for lichen planus, it can become dormant with treatment.

After the transplant, I quickly found out that intercourse with my husband was very painful. It turns out that you can get strictures not only in your esophagus, but also in your vagina!

I have had extensive vaginal GVHD and have also lost most of my pubic hair. After I developed a vaginal constriction, surgery made things better, but still left me uncomfortable.

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