Genitals and Chronic GVHD

Chronic graft-versus-host disease can affect the genitals and can cause pain and sexual difficulties for both men and women.

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Sometimes, chronic GVHD affects the genitals. In women, chronic GVHD can cause:

  • vaginal itching, burning, dryness
  • white lines, scarring, adhesions in the vagina
  • loss of elasticity in the vagina or narrowing of the vaginal canal
  • painful intercourse
  • pain when urinating bleeding

Treatment options may include:

  • hormone replacement therapy
  • water-based lubricants
  • topical steroids
  • tacrolimus or cyclosporine ointment
  • vaginal suppositories
  • dilators to expand the vaginal canal

A pelvic floor physical therapist can help relieve symptoms. Find a pelvic floor physical therapist at

Watch this video about how pelvic floor physical therapy for GVHD patients.  Click here to read the transcript of this video.


In men, GVHD can affect the penis. Symptoms include:

  • a change in skin color on the head of the penis
  • redness, white lines, burning or pain on the head of the penis
  • difficulty or pain when retracting the foreskin
  • scarring or adhesions on the foreskin
  • in rare cases, scarring on the meatus (where the urine comes out)

Topical steroids and tacrolimus are the usual treatment options.

Take Action!

  • If you have symptoms of genital GVHD, ask for a referral to a gynecologist or urologist familiar with GVHD.
  • To minimize irritation and pain:
    • wash your genital area with warm water and soap
    • don’t use perfumed products in the genital area
    • wear loose cotton or cotton-lined underwear

Topical steroids and tacrolimus are the usual treatment options.

Genital GVHD can cause difficulty with sex and intimacy in both men and women. To learn more about managing sexual difficulties after transplant click here.

Watch a video about Genital GVHD:


If you use social media, learn more about living with graft-versus-host disease and advances in treatment at #GVHD. Connect with others and show your support for GVHD patients.

(To view this page in Spanish click here.)

Next page: Nervous System and Muscular GVHD

Updated July 2023