This is especially helpful for those patients experiencing dyspareunia. Decreased vaginal lubrication can cause itchiness, burning and painful intercourse. It is helpful to explain what estrogen does and how the patient's estrogen has been decreased by the treatment. The most helpful intervention is the use of water based lubricants. Many of these are over the counter products and can be purchased at most pharmacies.
Depression can also be a side effect of the treatment, which can be physiological or psychological.
This can be related to hormonal changes or to the patient's cancer diagnosis. Some of the side effects are hematuria, contracted bladder and urethra or bladder neck obstruction. Some symptoms which may occur anywhere from 6 - 18 months after treatment are rectal bleeding, intestinal obstruction and necrosis, fistulas, proctitis , colitis, enteritis, ulceration of the mucosa and abcess. Fistulas are most common in women due to the close proximity of the vaginal canal and the rectum. These fistulas are not as common as in the past, due to the changes in technology and treatment planning used in planning the radiation treatment.