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Cancer of the uterus

Managing side effects


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. 

Some treatment side effects, called late effects, may not show up for many months or years.


If both ovaries have been removed or if you’ve had radiation therapy to the pelvic area, you will no longer produce oestrogen and progesterone 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, some treatments will cause sudden menopause. If you have already been through menopause, the symptoms of menopause may come back. These 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 menopausal symptoms

  • Vaginal moisturisers available over the counter at pharmacies can help with vaginal discomfort and dryness.
  • Your doctor can suggest non-hormonal medicines to relieve the symptoms of menopause.
  • If your menopausal symptoms are severe, talk to your doctor about the risks and benefits of taking menopause hormone therapy (MHT), previously called hormone replacement therapy (HRT). 
  • Talk to your doctor about having a bone density test or taking medicine to prevent your bones from becoming weak. Regular exercise will also help keep your bones strong.
  • Ask your doctor for a referral to a specialist menopause clinic if needed.
  • Have your cholesterol levels checked. If they are high, regular exercise and a balanced diet may help. Cholesterol-lowering drugs are also available.
  • Learn meditation and relaxation techniques, which may reduce stress and lessen some of the symptoms of menopause.
  • Several types of psychological therapies have been shown to help with menopause-related anxiety, low mood, sleep troubles and the impact of hot flushes.
  • Exercise can also help with mood changes and energy levels.

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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.

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Fertility issues

Surgery or radiation therapy for cancer of the uterus may mean you are unable to become pregnant. It may be possible to preserve the ovaries and sometimes the uterus so you can still have children. However, this is not standard treatment and is an option only in certain cases.

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 not unusual.

Speaking to a counsellor or a cancer nurse about your feelings and individual situation can be helpful. You can also call Cancer Council on 13 11 20 to talk to a health professional about your concerns.


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.

Managing fatigue

  • Do some light exercise, such as walking or stretching, to help increase your energy levels. Ask 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 and driving. Contact your local council to see what services they offer.
  • Learn to recognise signs of tiredness before you feel exhausted.
  • Talk to your employer about taking time off, 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.

Urinary incontinence

This is when you have trouble controlling your bladder and leak urine (pee). Strengthening your pelvic floor muscles with pelvic floor exercises can help control the flow of urine. Using continence pads can help you manage any leakage and prevent any embarrassing accidents. Contact the National Continence Helpline on 1800 33 00 66  for more information. 

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 wee. This is known as radiation cystitis. Try to drink plenty of water to make your urine less concentrated. Urinary alkalisers (e.g. Ural) are available over the counter from pharmacies and can help to reduce the burning sensation. 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 and keep in mind that it may not be related to your treatment. 

Bowel changes

Surgery, radiation therapy and medicines can cause changes to the way the bowels work. These changes are usually temporary, but for some people, they are permanent and can have a significant impact on quality of life.


Constipation is when you have difficulty having a bowel movement 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. Ways to manage constipation include:

  • Drink more water – aim for at least 8 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.
  • 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 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. Ways to manage diarrhoea include:

  • 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 (small amounts of cheese and yoghurt are usually okay).
  • Take medicines for diarrhoea as directed by your doctor.

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).

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. 

Lymphoedema and cellulitis

After surgery or radiation therapy to the pelvic area, one or both legs, and/or the vulvar area, may become swollen This is known as lymphoedema. It can happen if 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 of the legs may become infected more easily after lymph glands are removed. A common skin infection is called cellulitis. Signs of cellulitis include redness, painful swelling in the legs, warm skin and fever. If you have any symptoms, see your GP as soon as possible. Keep the skin healthy and unbroken to reduce the risk of infection. 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.

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 very dry. These side effects may make vaginal examination by a doctor uncomfortable or difficult, and make it painful to have sex.

Even if you don't plan to have sex again, your doctor will need to do regular pelvic examinations after treatment. Your treatment team may recommend using a vaginal moisturiser or lubricant (available over the counter from pharmacies) or a hormone cream (available on prescription and safe with many uterine cancers). They may also advise you to start using vaginal dilators (or have sexual intercourse regularly) some weeks after radiation therapy ends.

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 sexuality

Cancer of the uterus can affect your sexuality in both physical and emotional ways.

Some treatments for cancer of the uterus 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 also advise using vaginal dilators, lubricants, moisturisers or hormone creams. It may be helpful to explore ways of 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. 

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 or spread.

During check-ups, you will usually have a pelvic examination and you may have imaging scans.

Question checklist

Some useful questions to consider asking your doctor include:

  • 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?
  • 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?
  • 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 menopausal 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?
  • 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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Expert content reviewers:

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

Page last updated:

The information on this webpage was adapted from Understanding Cancer of the Uterus - A guide for people with cancer, their families and friends (2023 edition). This webpage was last updated in November 2023. 

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