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Sexual Dysfunction in Women Post-Cancer

This document discusses sexual dysfunction in women who have been treated for cancer. It notes that with advances in cancer detection and treatment, more survivors are living longer, and survivorship issues like sexual health have become more prominent. For female cancer survivors, gynecological issues are a major concern, as cancer treatments can directly impact sexual function through surgical impacts on anatomy, hormone changes from ovarian removal, and chemotherapy side effects. The article focuses on dyspareunia (painful intercourse) and vaginal stenosis, two common sexual dysfunction scenarios in this population, and notes that while some specialized cancer centers have sexual health programs, expert consultation is often not widely available for survivors.

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Robertus Hajai
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21 views2 pages

Sexual Dysfunction in Women Post-Cancer

This document discusses sexual dysfunction in women who have been treated for cancer. It notes that with advances in cancer detection and treatment, more survivors are living longer, and survivorship issues like sexual health have become more prominent. For female cancer survivors, gynecological issues are a major concern, as cancer treatments can directly impact sexual function through surgical impacts on anatomy, hormone changes from ovarian removal, and chemotherapy side effects. The article focuses on dyspareunia (painful intercourse) and vaginal stenosis, two common sexual dysfunction scenarios in this population, and notes that while some specialized cancer centers have sexual health programs, expert consultation is often not widely available for survivors.

Uploaded by

Robertus Hajai
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as RTF, PDF, TXT or read online on Scribd

Sexual

dysfunction in women

with

cancer
,.b Sandy J. Falk, M.D. and Don S. Dizon, M.D. .d
b c

a Sexual Health Program, Dana Farber Cancer In titute! De"artment o# $b tetric , %ynecology, and &e"roducti'e Medicine, Har'ard Medical School, Har'ard (ni'er ity, De"artment o# Internal Medicine, Har'ard Medical School, Har'ard (ni'er ity, and $ncology Sexual Health, Ma achu ett %eneral Ho "ital Cancer Center, )o ton, Ma achu ett
d

*""roximatel +, million "eo"le ha'e a hi tory o# cancer in the (nited State alone, and the number i ex"ected to increa e -ith time. .hi ha "rom"ted an a""reciation o# the /uality o# li#e ur'i'or . 0omen treated #or cancer identi#y gynecologic i u a a ma1or concern for both general health and the negati'e im"act on exual #unction that #ollo- the cancer diagno i and ub e/uent treatment. Unfortunately, issues related to sexual health continue to be undera""reciated. *lthough com"rehen i'e cancer center ha2e ado"ted specialized centers for survivorship issues, including tho e in'ol'ing exual health, con ultation are not -idely a'ailable in mo t communities. We provide background information on treatment exual health, examine the im"act 13 1 ! c a n t s t r e a t m e n t t O n " s e x uand a l # f u n c t i o n , s o the m e o # C m a 1 o rhealth i ue 3+ $omen $ho have received a cancer diagnosis and been ub e/uently treated. 4Forti Steril5 !%1"&1%%'1()!1. %!%1" by *merican +ociety for &e"roducti'e Medicine.6
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With ad'ance in early detec2 t i o n a n d t r e a t m e n t # o r c a n c e r , t h e n u m b e r o # u r ' i ' o r rnntinues to increase) and accordingly there has been an increased a$areness of survivorship issues. It i e timated that a o# January >3+> there -ere +?.@ million "eo"le -ith a hi tory o# cancer in the (nited State , and the number i ex"ected to increa e to +A million by >3>> 4+6. For #emale cancer ur'i'or , gynecologic i ue are a ma1or concern, and man y o# the e i ue im"act exual #unction. Some tertiary care center ha'e de'elo"ed exual health "rogram "eci#ically #or thi "atient "o"ulation, but ex"ert con ultation are not -idely a'ailable. In addition, mo t oncologi t are un able or un-illing to di cu exuality a n d i n t i m a c y i n t h e c o n t e x t o # a #ollo-2u" oncology 'i it becau e o# their lack o# training in thi area, "er

onal di com#ort, or time con traint . In te ad, the e i ue are rarel y ad dre ed, and -hen "atient a k about exual dy #unction, it i generally to the primary care physician or gynecologi t, -ho may be un#amiliar -ith the e i ue a they "ertain to -omen "re'iou ly treated #or cancer. In thi article, -e -ill re'ie- exual health i ue in -omen -ho ha'e had a cancer diagno i and ub e/uent treatment, and -e -ill #ocu in greater de"th on dy "areunia and 'aginal teno i , t-o o# the mo t common or igni #icant clinical cenario .
2

OVERVIEW OF SEXUAL DYSFUNCTION IN WOMEN TREATED FOR CANCER


Sexual health condition that a##ect -omen during or a#ter cancer treatment may be con idered according to the a m e c a t e go ri e a #e m a l e e xu a l dy #unction in the general "o"ulation. .he *merican P ychiatric * ociation de#ine the #ollo-ing #emale exual di orde r 8 e xual i nte re t9arou al, orga mic, and genito"el'ic "ain9"enetration 4>6. Cancer and it treatment can directly cau e all o# the e condition . Surgical treatment can re ult in di tortion o# #emale anatomy, "articularly #or "atient -ith brea t or gynecologic cancer . In addition, the remo'al o # t h e o ' a r i e i n " r e m e n o " a u a l -omen lead to "remature meno"au e -ith re ultant hormonal and "hy ical change that can alter e'eral domain o# exual #unction. Surgical treatment can re ult in exual dy #unction #or -omen diagno ed -ith other tumor a -ell! a an exam"le, exual dy #unct i o n i o c c u r i n + A B a n d C D B o # -omen treated #or early tage rectal cancer 4?6.
Chemothera"y can re ult in y temic e##ect that dam"en both exual de ire and arou al. In addition, chemothera"y may induce o'arian #ailure -ith an acute and udden loss of e trogen. Eear total alo"ecia re ulting #rom the u e o# ome agent 4 uch a the anthracycline and taxane 6 can

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