Genitals and GVHD

Graft-versus-host disease can affect the genitals after a transplant and impact sexual function and satisfaction.

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Graft-versus-host disease affects up to 50% of women who have a transplant with cells from a donor (an allogeneic transplant), and 20% of men.

In women, genital GVHD can  affect both the vulva and vagina causing:

  • dryness, itching, ulcers and scarring in the vagina and on the external genital area
  • pain with sex
  • pain when urinating

Vulvar GVHD occurs more frequently than vaginal GVHD and typically starts 7-10 months after transplant.

Treatment options may include:

  • water-based lubricants
  • topical steroids
  • tacrolimus or cyclosporine ointments
  • vaginal suppositories
  • dilators to expand the vaginal canal
  • a surgical procedure to open the vaginal canal

Continuing to have sex after transplant, if possible, can help the vaginal canal to remain open.

To minimize pain and irritation:

  • wash your genital area with warm water and soap
  • don't use perfumed products in the genital area
  • use loose cotton or cotton-lined underwear

In men, chronic GVHD on the penis and scrotum can cause

  • itching or scarring  
  • a lace-like rash 
  • narrowing of the urethra, making it difficult to urinate

Topical steroids and tacrolimus are the usual treatment options.

Genital GVHD can cause difficulty with sex and intimacy in both men and women.  One study found more than 67% of men with genital GVHD reported erectile dysfunction. A second study found that up to 80% of female transplant survivors experience sexual dysfunction, with genital GVHD being one of the causes.

To learn more about managing sexual difficulties after transplant click here.

Watch a video about Genital GVHD:

(To view this page in Spanish click here.)

Next page: Nervous System and Muscular GVHD