Sexual Dysfunction in Women With Cancer: A Review of Available Interventions

According to a study published in the European Journal of Cancer Care, cancer diagnosis and treatment have varied social, psychological, and physical impact on sexual health and may decrease quality of life for women. 

The negative effect on sexual health for women occurs with all cancer types, but previous data focuses primarily on breast and gynecologic cancers.

For this study, the researchers compiled the findings from various studies, articles, and other literature published from 1990 to 2017 that incorporated multiple cancer types and stages, and examined the available biological and psychosocial interventions that address the sexual dysfunction that arises from cancer diagnosis and treatment.

Psychoeducation, cognitive behavioral therapy, couples-based interventions, couples counselling, targeted psychosexual therapy, yoga-based intervention, and mindfulness-based trainings are utilized to improve sexual dysfunction. Psychosocial and mind-body interventions have demonstrated significant improvements in sexual desire, arousal, orgasm, satisfaction, sexual distress, depression, and overall well-being.

Nonhormonal vaginal moisturizers are commonly utilized to treat the symptoms associated with vulvo-vaginal atrophy (VVA) in female patients with cancer and is used to improve overall vaginal tissue health, vaginal pH, and microflora profiles. Results from multiple studies are inconsistent, but evidence suggests the use of moisturizers are associated with significant benefit in subjective and objective measures of sexual function.

Local estrogen-based treatments are typically used to improve general vaginal health in women, but due to risks with cancer development or recurrence, they are conservatively used primarily in women who are not responsive to nonhormonal vaginal moisturizers and who have non-hormone receptor positive cancers.

Lubricants, intravaginal dehydroepiandrosterone (DHEA), microablative fractional CO₂ lasers, vaginal dilation, and pelvic floor physiotherapy are interventions that have shown promise in restoring sexual function, but will need further investigation to show significant efficacy.

The authors conclude saying “greater consistency and clarity in terms of operationalized definitions and measurement of sexual dysfunction, of sexual health-related distress, and of the complex, individually determined meaning of sexual well-being, may enhance the research methodology in this growing field.”

Reference

1. Sears CS, Robinson JW, Walker LM. A comprehensive review of sexual health concerns after cancer treatment and the biopsychosocial treatment options available to female patients [published online August 10, 2017]. Euro J Cancer Care. doi: 10.1111/ecc.12738