Page last updated: May 2026
The information on this webpage was adapted from Understanding Cancer of the Uterus - A guide for people affected by cancer (2025 edition). This webpage was last updated in May 2026.
Expert content reviewers:
This bookley is based on Australian and international clinical practice guidelines. All updated content has been clinically reviewed by Professor Alison Brand, Clinical Professor, The University of Sydney and Director, Department of Gynaecological Oncology, Westmead Hospital, NSW.
This edition is based on the previous edition, which was reviewed by the following panel of health professionals and people affected by cancer of the uterus:
- A/Prof Orla McNally, Consultant Gynaecological Oncologist, Director Oncology/Dysplasia, Royal Women’s Hospital, Honorary Clinical Associate Professor, University of Melbourne, and Director of Gynaecology Tumour Stream, Victorian Comprehensive Cancer Centre, VIC
- A/Prof Yoland Antill, Medical Oncologist, Peninsula Health, Parkville Familial Cancer Centre, Cabrini Health and Monash University, VIC
- Grace Guerzoni, Consumer
- Zeina Hayes, 13 11 20 Consultant, Cancer Council Victoria
- Bronwyn Jennings, Gynaecology Oncology Clinical Nurse Consultant, Mater Hospital Brisbane, QLD
- A/Prof Christopher Milross, Director of Mission and Radiation Oncologist, Chris O’Brien Lifehouse, NSW
- Mariad O’Gorman, Clinical Psychologist, Liverpool Cancer Therapy Centre and Bankstown Cancer Centre, NSW.
It will take some time to recover from the physical and emotional changes caused by treatment. Treatment side effects can vary – some people experience many side effects, while others have few.
Side effects may last from a few weeks to a few months or, in some cases, years or permanently. This page includes ways to reduce or manage the discomfort that side effects may cause.
Some treatment side effects may not show up for many months or years. These are called late effects.
Before treatment starts, talk to your doctor about whether you are at risk of developing late effects from your treatment and what you can do to help prevent them. After treatment, make sure to see your GP for regular health checks.
Menopause
The ovaries produce the hormones oestrogen and progesterone. If both ovaries have been removed or you’ve had radiation therapy to the pelvic area, your body will no longer produce these hormones and you will stop having periods. This is called menopause.
For most women, menopause is a natural and gradual process that starts between the ages of 45 and 55. If you have not already entered menopause, these treatments will cause sudden menopause.
If you have already been through menopause, the symptoms of menopause may come back. Menopause symptoms include:
- hot flushes
- night sweats
- dry or itchy skin
- mood swings
- trouble sleeping (insomnia)
- tiredness
- aching joints
- vaginal dryness
- weight gain, and
- bladder problems.
You may also have a decreased interest in sex (low libido). The symptoms of menopause caused by cancer treatment are usually more severe than during a natural menopause because the body hasn’t had time to get used to the gradual decrease in hormone levels.
Menopause may cause other changes in the body. For example, your cholesterol levels may rise, which can increase your risk of heart disease. Over time, your bones may become weak and brittle, and break more easily. This is called osteoporosis.
Radiation therapy to the pelvis can also weaken the bones.
Managing menopause symptoms
- Vaginal moisturisers available over the counter from pharmacies can help with vaginal discomfort and dryness. Talk to your nurse for suggested products.
- Your doctor may suggest using a vaginal oestrogen cream to help with vaginal dryness and prevent painful sexual intercourse.
- If you need to avoid products containing oestrogen, your doctor can suggest non-hormonal medicines to relieve the symptoms of menopause.
- If your menopause symptoms are severe, talk to your doctor about the risks and benefits of taking menopausal hormone therapy (MHT). Previously called hormone replacement therapy (HRT), MHT is not usually used if you have cancer of the uterus, but may be considered in some cases. If you were on MHT when the cancer was diagnosed, your doctor will usually advise stopping its use as oestrogen can cause these cancers to grow.
- Talk to your doctor about having a bone density test or taking medicine to prevent your bones from weakening. Visit Healthy Bones Australia for more information.
- Ask your doctor for a referral to a menopause clinic if needed.
- Have your cholesterol levels checked. If they are high, regular exercise and a balanced diet may help, or talk to your doctor about cholesterol-lowering drugs.
- Learn meditation and relaxation techniques. These may be helpful in reducing stress and some menopause symptoms.
- Some types of psychological therapy may help with menopause-related anxiety, low mood, sleep troubles and the impact of hot flushes. Talk to a psychologist about the best approach for you.
- Exercise can also help with mood and energy levels. Talk to an exercise physiologist or physiotherapist.
Your guide to best cancer care
A lot can happen in a hurry when you’re diagnosed with cancer. The guide to best cancer care for endometrial cancer can help you make sense of what should happen.
It will help you with what questions to ask your health professionals to make sure you receive the best care at every step.
Read the guide
Fertility issues
Surgery or radiation therapy for cancer of the uterus may mean you are unable to become pregnant. Before treatment starts, ask your doctor or a fertility specialist about what options are available to you if you were hoping to have a baby.
It may be possible to preserve the ovaries (e.g. if you are 45 years or under) and sometimes the uterus, so you can still have children. However, this is an option only in certain cases, and your doctor will explain the risks and benefits.
Learning that your reproductive organs will be removed or will no longer function and that you won’t be able to have children can be devastating. Even if your family is complete or you did not want children, you may still experience a sense of loss and grief.
These reactions are normal. Speaking to a counsellor, psychologist, social worker or a cancer nurse about your feelings and individual situation can be helpful.
Contact cancer support
Fatigue
It is common to feel very tired and lack energy during and after treatment. This can be a side effect of the treatment itself or a symptom of menopause.
Travelling to hospitals and clinics for treatment and appointments can be exhausting. Dealing with your emotions can also cause fatigue. Your tiredness may continue for a while after treatment has finished.
Fatigue may affect your ability to keep working or care for your home and family. It may help to talk with your family and friends about how you feel, and discuss ways they can help you.
To learn more, listen to the Managing Cancer Fatigue episode of Cancer Council's The Thing About Cancer podcast.
Managing fatigue
- Do some light exercise, such as walking or stretching, to help increase your energy levels. Check with your doctor if these activities are suitable for you. You can also ask for a referral to an exercise physiologist or physiotherapist.
- Plan your day. Set small, manageable goals so you can rest regularly, and allow yourself plenty of time to get to appointments.
- Ask for and accept offers of help from family and friends (e.g. with shopping, housework, meals and driving). Contact your local council to see what support services they offer.
- Learn to recognise signs of tiredness before you feel exhausted.
- Talk to your employer about taking time off work, reducing hours or working from home.
- Don’t expect to be able to instantly do everything you used to do. Your body is still recovering and it will take time for your energy levels to return.
Bladder changes
Treatment for cancer of the uterus can cause bladder problems. Most bladder side effects are temporary or can be managed.
If you have ongoing incontinence, you may be eligible for subsidised incontinence products through the continence aids payment scheme.
Urinary incontinence
This is when you have trouble controlling your bladder and you leak urine (wee). Strengthening the pelvic floor muscles can help control the flow of urine.
A women’s health physiotherapist or continence nurse can develop a bladder training program – ask your doctor for a referral or contact the National Continence Helpline.
You can also find a guide to exercising the pelvic floor muscles in our Exercise for People Living with Cancer booklet. Using continence pads or special types of absorbent underwear can help you manage leakage.
Radiation cystitis
Radiation therapy can irritate the lining of the bladder. You may feel like you want to pass urine often or have a burning sensation when you pass urine. Called radiation cystitis, it usually gets better after treatment.
Try to drink plenty of water or use a urinary alkaliser (e.g. Ural) to help reduce the burning sensation. You can buy urinary alkalisers from your pharmacy. Your doctor may also prescribe medicine to treat cystitis.
Blood in urine
The blood vessels in the bladder can become more fragile after radiation therapy. This can cause blood to appear in your urine, even months or years after treatment.
Always let your doctor know if you notice new or unusual bleeding.
Bowel changes
Treatment for cancer of the uterus can affect the way the bowels work. These changes are usually temporary, but for some people, they can be permanent and can have a significant impact on quality of life.
Talk to your treatment team if you are finding bowel issues hard to manage.
Constipation
Constipation is when you have difficulty having a bowel movement (pooing) regularly or often.
It is important to avoid constipation, especially in the days after surgery, because it may lead to more discomfort or cause you to strain when you’re sitting on the toilet.
Talk to your dietitian or doctor about making changes to your diet or taking medicines if you are constipated.
Diarrhoea
Diarrhoea is the frequent passing of loose, watery faeces (poo) from the bowels. A dietitian can suggest changes to your diet to reduce the number of bowel movements.
Radiation proctitis
Radiation therapy can damage the lining of the rectum, causing inflammation and swelling known as radiation proctitis. This can cause a range of symptoms including:
- blood in bowel movements
- diarrhoea
- the need to empty the bowels urgently, and
- loss of control over the bowels (faecal incontinence).
Radiation proctitis usually gets better after treatment has finished, but it can develop some time after treatment (called a late effect).
Talk to your treatment team about your risk of developing radiation proctitis. If you have any ongoing bowel problems, they may refer you to a gastroenterologist.
Blood in bowel movements
Blood vessels in the bowel can become more fragile after radiation therapy. This can cause blood to appear in your faeces, even months or years after treatment. Always seek advice from your specialist or GP if you notice any new or unusual bleeding.
Managing bowel changes
Constipation
- Drink more water – aim to drink at least eight glasses during the day.
- Eat regular meals throughout the day.
- Try to eat more fibre-rich foods (e.g. wholegrain breads and cereals, legumes such as beans and lentils, vegetables, fruits, nuts and seeds).
- Avoid drinking alcohol.
- Do some gentle exercise, such as walking. Check with your doctor about the amount and type of exercise that is right for you.
- Cut down on sweets, soft drinks, takeaway food, fried foods, potato chips and other savoury snacks.
- Limit foods containing added sugars and salts.
- Take medicines for constipation as directed by your doctor.
Diarrhoea
- Drink plenty of fluids such as water, herbal teas, sports drinks and electrolyte-replacing fluids.
- Avoid drinking alcohol.
- Eat fewer high-fibre foods (e.g. wholegrain breads and cereals, raw fruits and vegetables, legumes).
- Eat more low-fibre foods (e.g. white rice, white pasta, white bread, potatoes).
- Limit spicy, fatty and greasy foods, as these can make diarrhoea worse.
- Cut down on coffee, cola and other drinks that contain caffeine.
- Choose low-lactose or soy-based dairy products (eating small amounts of cheese and yoghurt is usually okay).
- Ask your doctor about suitable medicines for diarrhoea. Take as directed.
Lymphoedema and cellulitis
After surgery or radiation therapy to the pelvic area, one or both legs and/or the vulvar area, may become swollen.
Called lymphoedema, this occurs when lymph fluid doesn’t circulate properly and builds up. The swelling may appear during treatment or months or years later.
Lymphoedema can make movement and some types of activities difficult. It is important to maintain a healthy body weight, avoid pressure, injury or infection to the legs, and manage lymphoedema symptoms as soon as possible.
Mild lymphoedema is usually managed with exercise, skin care and a compression stocking.
To find a health professional who specialises in the management of lymphoedema, speak to your treatment team or visit the Australasian Lymphology Association.
The skin on the legs may become infected more easily after lymph nodes are removed. A common skin infection is called cellulitis. Signs of cellulitis include redness, painful swelling, warm skin and fever. If you have any symptoms, see your GP as soon as possible.
To reduce the risk of infection, keep the skin healthy and unbroken, exercise regularly and avoid tight-fitting clothing.
Use moisturiser and sunscreen, and avoid scratches, cuts, burns, insect bites, and injections in your legs. Also, keep your feet clean and dry to avoid fungal infections.
If your GP refers you to an allied health professional (such as a physiotherapist) as part of a chronic disease management plan, you may be eligible for a Medicare rebate for up to 5 visits each year. Ask your GP for more details.
Vaginal narrowing and dryness
Radiation therapy to the pelvic area can cause vaginal tissue to lose its elasticity and shrink, narrowing the vagina (vaginal stenosis). If your ovaries were removed, your vagina may also become dry.
These side effects may make it painful to have sex or pelvic examinations. Even if you don’t plan to have sex again, your doctor will need to do regular pelvic examinations after treatment, so it is important to prevent these side effects.
Your treatment team may recommend using a vaginal moisturiser or lubricant or a hormone cream (available on prescription and safe with many cancers of the uterus). They may also advise you to use vaginal dilators.
Using vaginal dilators
Vaginal dilators can help keep your vagina open and flexible after treatment. They are made from plastic or silicone and come in a range of sizes.
You usually start with the smallest dilator, and as each one becomes more comfortable, you can move on to using the larger dilators.
Make sure any soreness has settled down before you start using dilators (usually 4–6 weeks after your last radiation therapy session).
To use the dilator, find a private space. Apply a water-based lubricant to the dilator, slowly insert it into the vagina, then gently rotate it. Leave the dilator in for 5–10 minutes.
You can do this once or twice a day for the first few months, and then 2–3 times a week for several months after that, as advised by your treatment team.
You may also like to see a women’s health physiotherapist. If you have a history of sexual trauma, speak with a psychologist or counsellor.
Impact on sex and intimacy
Cancer of the uterus can affect your sex life in both physical and emotional ways. Some treatments can cause dryness and narrowing of the vagina, which can make sexual penetration difficult or painful.
Also, removal of the uterus, cervix and ovaries can change how you experience sexual pleasure and orgasm. Your treatment team may advise using vaginal dilators, lubricants, moisturisers or hormone creams.
It may be helpful to explore ways to orgasm (climax) without penetration or to use masturbation to see what might work for you. You may lose interest in intimacy and sex (low libido) because of:
- the hormonal changes of menopause
- the stress of the cancer experience
- the fatigue caused by treatment, and
- changes in how you feel about your body (body image).
It may help to remember that for most people, sex is more than arousal, intercourse and orgasm. It involves feelings of intimacy and acceptance, as well as being able to give and receive love. Closeness and sharing can still be part of your relationship.
If you have a partner and do not feel like having sexual intercourse, or if you find it uncomfortable, talk openly with them about how you’re both feeling, and take things slowly by starting with hugs or a massage rather than penetrative sex.
You may both need to be patient – things often improve with time and practice. If you have ongoing concerns about how treatment has affected your sex life, talk to your GP or gynaecological oncologist or ask for a referral to a psychologist or sexual therapist.
To learn more, listen to the Sex and Cancer episode of Cancer Council's The Thing About Cancer podcast.
Sex and intimacy
Effect on your emotions
Changes to your body can make you feel self-conscious and affect the way you feel about yourself (your self-esteem). You may feel less confident about who you are and what you can do.
It is normal to experience a wide variety of emotions after treatment, including anger, fear and resentment. Everyone has their own ways of coping with their emotions.
It is important to give yourself and those around you time to deal with the emotions and adapt to the changes that cancer can cause.
Call Cancer Council 13 11 20 for help and support. You may also find it helpful to see the psychologist in your cancer centre about the impact of cancer on your mental health.
Emotions and cancer
Follow-up appointments
After treatment ends, you will have regular appointments with your specialists to monitor your health, manage any long-term side effects and check that the cancer hasn’t come back (recurred) or spread.
If you have a low risk of recurrence, your follow-up care may be shared between your cancer specialist and GP, or you may be discharged to your GP with easy access back to your specialist if needed.
During check-ups, you will usually have a pelvic examination and you may have imaging scans. Follow-up appointments will start immediately after treatment, then become less frequent over time.
How often you see your doctor will depend on the type and stage of the cancer.
When a follow-up appointment is approaching, many people find that they think more about the cancer and may feel anxious. If you are finding this hard to manage, talk to your doctor or call Cancer Council 13 11 20.
What if the cancer returns?
For some people, cancer of the uterus does come back after treatment (called a recurrence).
This is why it’s important to have regular check-ups and to immediately report any symptoms (e.g. vaginal bleeding, pain in the abdomen, swelling, unexpected weight loss, unexplained cough), rather than waiting for your next follow-up appointment.
Most cancers of the uterus that come back do so in the first 2–3 years after treatment. If you have had a hysterectomy, cancer of the uterus usually comes back in the vagina or pelvic lymph nodes.
It is also possible for the cancer to come back in another part of the body. If the cancer does recur, you will usually be offered further treatment to remove the cancer or help control its growth.
Question checklist
Asking your doctor questions will help you make an informed choice. You may want to include some of the questions below in your own list.
Diagnosis
- What type of cancer of the uterus do I have?
- Has the cancer spread? If so, where has it spread? How fast is it growing?
- Are the latest tests and treatments for this cancer available in this hospital?
- Will a multidisciplinary team be involved in my care?
- Are there clinical guidelines for this type of cancer?
Treatment
- What treatment do you recommend? What is the aim of the treatment?
- Are there other treatment choices for me? If not, why not?
- If I don’t have the treatment, what should I expect?
- How long do I have to make a decision?
- I’m thinking of getting a second opinion. Can you recommend anyone?
- How long will treatment take? Will I have to stay in hospital?
- Are there any out-of-pocket expenses not covered by Medicare or my private health cover? Can the cost be reduced if I can’t afford it?
- How will I know if the treatment is working?
- Are there any clinical trials or research studies I could join?
Side effects
- What are the risks and possible side effects of each treatment?
- Will I have a lot of pain? What will be done about this?
- Can I work, drive and do my normal activities while having treatment?
- Will I still be able to have children? Should I see a fertility specialist?
- What can I do to manage menopause symptoms?
- Will the treatment affect my sex life?
- Should I change my diet or physical activity during or after treatment?
- Are there any complementary therapies that might help me?
After treatment
- How often will I need check-ups after treatment?
- If the cancer returns, how will I know? What treatments could I have?
Understanding Cancer of the Uterus
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