Interventions to Improve Sexual Health in Women Living with and Surviving Cancer: Review and Recommendations.

Jenna Sopfe,Jessica Pettigrew,Leslie C Appiah,Helen L Coons,Anosheh Afghahi

doi:10.3390/cancers13133153

Abstract

Simple SummarySexual health, both physical and psychological, is a common concern and unmet need among women with and surviving cancer. To guide clinical care and future research to improve sexual function and satisfaction in women with cancer, we performed a narrative review of interventions for sexual health concerns including sexual function, body image, genitourinary symptoms, and hot flashes. Relevant investigations conducted in the US and abroad published between 2005 and 2020 were reviewed (n = 91). Recommendations for future research in this area are also offered.Sexual health concerns, both physical and psychological, are common and represent an unmet need among women with and surviving cancer. Sexual challenges and conditions negatively impact body image, satisfaction, relationships, well-being, and quality of life, yet are widely reported to be under-recognized and undertreated. To guide clinical care and future research on sexual function in women with cancer, we performed a scoping review of interventions for sexual health concerns, including sexual function, body image, genitourinary symptoms, and hot flashes. Relevant publications between 2005 and 2020 were identified by searching PubMed with a combination of medical subject headings and keywords. Articles were included if they focused on the aforementioned topics, were primary research publications, and included female cancer survivors. Studies focusing on women receiving hormone therapy for breast cancer were also included. A total of 91 investigations conducted in the US and abroad were reviewed. Most commonly, interventions included a component of psychoeducation, although pharmacologic, exercise, and other approaches have been evaluated. Many studies have focused on survivors of breast or gynecologic cancer, among other sampling and methodological limitations. These limitations underscore the need for more work on this vital survivorship issue. Recommendations for future research in this area are also offered.

Highlights

Sexual health, a key component of physical and emotional well-being and quality of life, is frequently negatively affected by cancer and its treatments
An additional 296 were excluded for various reasons (Figure 1), resulting in 91 articles included in this review
While sexual concerns after cancer are present in a variety of ways depending on the patient’s medical and social history, many studies have evaluated interventions to improve sexual function and satisfaction, in general, in women or women and their partners

Summary

Introduction

A key component of physical and emotional well-being and quality of life, is frequently negatively affected by cancer and its treatments. Survivors experience a wide range of conditions, including arousal difficulties, vaginal dryness/atrophy, decrease in orgasm intensity or frequency, diminished sexual pleasure and desire, and dyspareunia, all of which can be complicated by and contribute to changes in body image and sexual-self-esteem [1,6]. Each of these aspects of sexual health may be affected by cancer and/or treatment, including systemic chemotherapy, targeted agents, immunotherapy, surgery, radiotherapy, and hormonal therapy. The pathophysiology varies, but includes anatomic, neurologic, and hormonal changes, such as a loss of sensation and premature menopause and psychological and social challenges related to cancer therapy and survivorship [1,2,7,8,9]

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