Sexuality in patients with gynecologic cancer

#Gynecologic cancers are anticipated to result in over 110,000 new cancer cases and over 32,000 cancer deaths in 2018. Uterine #cancer is estimated to be the fourth leading cause of cancer. Moreover, ovarian and uterine cancers are estimated to be the fifth and sixth leading causes of death, respectively, among women in the United States.

The #treatment for gynecologic cancer generally includes surgery, chemotherapy, radiation, or a combination of these modalities. Patients are typically followed for 5 years by the time of the completion of treatment when at that time they enter the survivorship phase of a cancer diagnosis.

Sexual function and psychosexual #wellbeing are receiving more attention in research and clinical practice as the number of cancer survivors increases. Thousands of women are living with either active disease or a history of gynecologic cancers which can result in multifactorial sexual consequences, including but not limited to challenges with sexual interest and arousal, orgasm, pain, and induced menopause.

Approximately 50% of women with gynecologic cancer are estimated to experience acute or chronic sexual health dysfunction. Evidence shows that cancer dramatically impacts a woman’s sexuality, sexual functioning, intimate relationships, and sense of self.


Depression, anxiety, body image, and the ability to “feel like a woman” are correlated with levels of sexual functioning.

Understanding of baseline sexual function, the role of psychological supports, and available treatment options could reduce the heavy burden of decreased sexual function.

Sexual dysfunction, which is one of the most common and distressing quality-of-life issues that female cancer survivors face, is rarely discussed. Patients are not consistently questioned about this subject during cancer treatment visits or examinations. This is further complicated by diverse religious, political, and philosophical perspectives on sexuality. These challenges are present both for oncologists and primary care providers who report limitations, including lack of training in sexual health and the belief that there are no effective treatments for sexual dysfunction, as well as discomfort with sexual health conversations.

The American Society of Clinical Oncology recommends initiating discussion of sexual health at the time of the diagnosis and readdressing it throughout the treatment and survivorship. A conversation initiated by the health care provider opens the door for the patient to feel more comfortable discussing the topic of sexuality and sexual health issues.

Understanding the potential sexual health consequences of gynecologic cancers is crucial for supporting informed conversations between patients and providers.

Source: Sexuality and Menopause: Unique Issues in Gynecologic Cancer
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