Symptoms of PRD

Pelvic radiation disease (PRD) symptoms come in two different forms:

1. Symptoms that begin around the time of treatment, but then carry on for longer than 6 months after it has ended
2. Symptoms that begin several months, years or even decades after the radiotherapy treatment is finished [1].

PRD is different from the symptoms that most women experience during their radiotherapy, which usually go away within a few weeks or months of treatment ending and can often be managed with medication. These immediate symptoms are sometimes known as ‘acute’ symptoms, compared with the long term or ‘chronic’ symptoms that women with PRD suffer from [2]. The chronic symptoms are the ones that are often misdiagnosed.

PRD can cause a variety of short and long term physical symptoms to the organs and tissues within the pelvis, these can range from mild to severe.

The most common symptoms are listed below [1][3][4].

• Bowel:
• Needing to empty bowels more often (frequency) or in a rush (urgency)
• Diarrhoea or constipation
• Bowel/tummy cramps and pain
• Leakage from the bottom or having accidents where you can not control your bowels (incontinence)
• Bleeding from the bottom
• Blood or mucus (clear and sticky) in stools (poo)
• Difficulty emptying bowels
• Feeling that the bowels haven’t been completely emptied
• Passing a lot of wind.
• Bladder:
• Passing a lot of wind.
• Increased urgency or frequency in passing urine
• Pain or burning sensation when passing urine (like cystitis)
• Leaking urine or having accidents where you cant hold in urine (incontinence)
• Blood in urine
• Difficulty passing urine
• Feeling the need to pass urine even when the bladder is empty.
• Vaginal changes:
• Vaginal narrowing (called stenosis – the walls of the vagina can stick together)
• Difficulty having, or pain/discomfort during penetrative sex
• Vaginal bleeding (the walls of the vagina may become more fragile with the blood vessels closer to the surface, which together can cause bleeding) 
• Vaginal dryness.
• Early menopause:
• Hot flushes, sweats and sometimes palpitations
• Loss of libido
• Mood swings and irritability
• Dry skin, hair and nails.
• Lymphoedema:
• Swelling of one or both of your legs
• Swelling of your lower tummy and genitals. 
• Bones:
• Pain in your lower back or pelvis when you are moving around
• Aching in your hips and pelvis.

The physical symptoms of PRD can also affect the quality of life of those who suffer from them. This can be just as difficult to cope with as the physical symptoms. The psychological symptoms can include changes to a woman’s:

• Mood
• Social life
• Family life
• Finances
• Intimate relationships
• Sex life and sexual desire 

The below video features a medical expert discussing the possible symptoms of PRD, when they might start and where to find support. It also features two women who are living with this condition talking about their experiences with PRD and how they manage the symptoms.