Sexuality after Gynecologic Cancer

For many women who survive gynecologic cancers and their treatment, life after cancer includes learning to cope with serious, long-term sexual problems. In a survey of 200 survivors of ovarian cancer, more than half of the women reported that their sex lives had been negatively affected by cancer or its treatment, and 75% described their sex lives as poor to adequate. In studies of women treated for cervical or endometrial cancer, anywhere from 31% to 88% reported problems with sexuality, particularly those who underwent radiotherapy.

Survivors of gynecologic cancer report a range of sexual difficulties; decreased libido, vaginal dryness, and pain during intercourse are the most prevalent. These problems can arise from multiple causes, including vaginal stenosis after radiotherapy, surgical or treatment-related menopause, disturbed body image, and increased psychologic distress.

Given the high prevalence of sexual difficulties after gynecologic cancer, health-care providers should ask patients about sexual functioning problems as a normal part of their follow-up examination. Many patients are reluctant to ask questions, but they need information about the possible causes of problems and how to overcome them. For example, they need to know that vaginal dryness is a common outcome after surgery to remove the ovaries and that various lubricants or hormonal supplements can help remedy the problem. Dilators are helpful to women who have had pelvic radiation, to prevent or treat narrowing of the vagina; however, patients may need instruction in how to use them. Health-care providers should follow up with patients at the next appointment to determine whether the intervention prescribed is working and to suggest alternatives or provide assistance if needed.

Psychoeducational group interventions, which provide opportunities for emotional expression and problem solving, have been shown to improve sexual functioning among gynecologic cancer survivors. Such group programs are not readily available, however, and so some patients and their partners may instead benefit from working with a sex therapist. The American Association of Sex Educators, Counselors, and Therapists can assist with identifying a credentialed sex therapy professional.

The American Cancer Society has published two books on sexuality after cancer, one for men and one for women; to request a free copy call the American Cancer Society at 1-800-ACS-2345. The book Sexuality and Fertility After Cancer, by Leslie R. Schover, Ph.D., (John Wiley & Sons, 1997) is also an excellent resource.

Through communication, appropriate medical interventions, and education, health-care teams can give survivors of gynecologic cancer the support they need to return to healthy and enjoyable sexual function.

For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call the M. D. Anderson Information Line at (800) 392-1611 (in the United States) or (713) 792-3245 (in Houston and outside the United States).

Other articles in OncoLog, October 2004 issue:

• Treating Head and Neck Cancer Requires Extraordinary Coordination Among Disciplines
• Researchers Seek to Understand the Mysteries of Uterine Cancer and to Find Better Treatments
• Mammography vs. Magnetic Resonance Imaging: A Breast Cancer Prevention Specialist and a Radiologist Weigh in on the Recent Debate
• House Call: The Role of Alcohol and Tobacco in Head and Neck Cancer

TOP

Home/Current Issue | Previous Issues | Articles by Topic | Patient Education
About Oncolog | Contact OncoLog | Sign Up for E-mail Alerts

©2008 The University of Texas M. D. Anderson Cancer Center
1515 Holcombe Blvd., Houston, TX 77030
1-877-MDA-6789 (USA) / 1-713-792-3245  
 Patient Referral    Legal Statements    Privacy Policy