Radiation therapy affects the vaginal environment as well as the body, causing the vagina to become shorter, narrower, drier and less flexible. Patients may experience painful intercourse during sexual intercourse. In addition, this change can interfere with gynecological examinations, which can be significant for patients after treatment. There are a range of methods that can promote a healthy vaginal state in patients after radiotherapy, and the following methods can be applied optionally. Vaginal moisturizer Vaginal moisturizer is a non-hormonal, over-the-counter medication that relieves vaginal dryness and discomfort. It is available in major pharmacies and online stores. Without special circumstances, application of any of the following products 2-3 times a week is sufficient to relieve symptoms. However, many women after oncology treatment or sudden menopause need to increase the frequency of application to about 3-5 times per week. Vaginal moisturizers are most effective when applied at bedtime. These moisturizers are: 1. Vitamin e liquid capsules Poke the ends of a vitamin e capsule and slowly place it into the vagina. Or squeeze the contents of the capsule onto your finger and apply it evenly to the vaginal wall. 2. Replens, Hyalo GYN These vaginal moisturizers are applied through an applicator into the vagina. Applying an appropriate amount of lubricant to the tip of the applicator can reduce discomfort during insertion. Carlson KEY-E Suppositories; K-Y Brand LIQUIBEADS These are suppositories that are inserted into the vagina through a disposable applicator and an appropriate amount of lubricant is applied to the tip of the applicator to reduce discomfort during insertion. Many women experience dryness and discomfort in the vulva. Using a vulva moisturizer can increase comfort. Natural oils such as vitamin E or coconut oil have this effect. You can also use Reblochon or long-acting vaginal lubricants on your vulva. Vaginal lubricants are often made in water or gel form. It is often used as a supplement to a woman’s own lubrication to reduce vaginal dryness and relieve painful intercourse. The application of such lubricants can enhance the comfort and pleasure of sexual intercourse. Apply the lubricant to the vaginal opening or to any object that enters the vagina such as an applicator, dildo, finger, or penis. Avoid using dyed, flavored and heated lubricants and spermicides. Do not use mineral oil or petroleum jelly because they are not easily cleaned, are irritating to the vagina, and increase the risk of vaginal infection. Vaginal hormones Please apply vaginal estrogens under the guidance of a medical professional. Before doing so, please make sure that you have discussed the principles of use of the following medications with your doctor. 1. Estradiol vaginal tablets Estradiol vaginal tablets can be placed in the vagina through the applicator at bedtime. After 14 days of continuous use, switch to twice weekly application. 2. Estrogen vaginal ring The estrogen ring is placed in the vagina and pushed back as far as possible and removed 90 days after placement. V. Vaginal dilatation therapy Vaginal dilators dilate the vagina and help keep the tissues inside the vagina supple. It can even be used during sexual intercourse. Vaginal dilatation is a life-long procedure that has the following benefits: 1. Creates a more thorough pelvic examination for health care providers 2. Reduces discomfort during gynecological examinations. 3. (Preventing the vagina from becoming too narrow) preventing the vagina from becoming even narrower. 4. Maintain vaginal elasticity. 5.Reduce the discomfort during sexual life. You can start applying vaginal dilators after completing the treatment. Your health care provider will advise you on the safest time to start using it and how often to use it. Your nurse will retrieve the dilator for you and give you instructions on how to use it. Your doctor should decide when to start using the vaginal dilator and how many times a week to use it. Applying a vaginal lubricant before applying a vaginal dilator can reduce discomfort. When you tell your health care provider that you are experiencing pain during vaginal dilator application, they may have the following suggestions: prescribe something to help relieve the pain; suggest that you go to a sexual medicine clinic for advice and help; refer you to a physical therapist for help. Steps to apply a vaginal dilator: 1. Preparation before the application of a vaginal dilator begins Pick a time and place where you can be private and fully relaxed. Most women find the bedroom to be the most comfortable location for vaginal dilatation therapy. Lie flat with your knees bent at 45 degrees, spread your legs shoulder-width apart and relax your legs. Make sure you can easily touch the vaginal opening and apply a mirror if necessary. Locate the pelvic floor muscles and perform Kegel exercises according to the instructions. 2. Placement of vaginal dilators Generally, the gradual and slow placement of vaginal dilators is simple and does not cause any discomfort. Start with the smallest vaginal dilator and gradually increase the size of the dilator as you go along. This will improve the discomfort of intercourse. Apply a water-based lubricant such as Astroglide, K-Y, but not Vaseline, to the vaginal opening and dilator; insert the round head of the dilator slowly and gently into the vagina (always parallel or slightly upward, never downward); insert the dilator until you experience slight discomfort or tension in the pelvic floor muscles. The process of inserting the vaginal dilator will be comfortable rather than painful. Do not use violence or cause pain); do a set of Kegel exercises as instructed to relax the pelvic floor muscles and allow deeper insertion of the vaginal dilator (if insertion is still difficult after Kegel exercises, breathe deeply and focus on the pelvic floor muscles, do not worry about not being able to fully insert the vaginal dilator, it can be done after relaxing); hold the vaginal dilator in place for 5-10 minutes; gently push and pull the vaginal dilator to extend the length of the vagina. the vaginal dilator to extend the length of the vagina; and gently rotate the vaginal dilator at a wide angle to expand the width of the vagina. Repeat these movements in the anterior and posterior regions of the vagina. After each use, remove the dilator from the vagina, wash it with hot soapy water, wipe it clean with a clean towel and store it in the storage box as directed. A small amount of bleeding during vaginal dilator use is normal and a sanitary napkin is sufficient. If more bleeding occurs, prompt medical attention is required. If you have an urge to urinate during the dilation treatment, this may indicate a urinary tract infection. If you have any other questions, please ask them at your next appointment. 4. Goal of vaginal dilatation treatment When one model of vaginal dilator is fully inserted without any discomfort, you can start applying the next model of vaginal dilator. The goal of treatment is to slowly increase the size of the vaginal dilator to the largest possible size that can be placed without any discomfort. Vaginal dilatation should be done several times a week, and the more often you do it, the more you will benefit from it. If you don’t have enough time to do this exercise, you should still try to do Kegel exercises daily. If you forget to exercise or don’t exercise for a whole week, don’t give up and try to start again as soon as possible. Establishing a detailed plan or routine will help you do your workout better.