Cancer and Sexual Health

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“We know that cancer profoundly affects every aspect of life but one particular area that is often overlooked is its impact on sexual health.”

Manta Singhvi, MD

It’s probably not the first think that comes to mind when you think about cancer but the impact on sexual function can be dramatic, especially for women undergoing treatment for cervical and other gynecologic cancers. In this Q&A, Dr. Mamta Singhvi talks about common sexual health issues that arise for women with gynecologic cancers and offers some solutions. She also explains that health care providers, patients, and partners all have a role in the process.

What kind of physical changes might occur with cervical cancer treatment that can make sex and intimacy challenging?
We know that cancer profoundly affects every aspect of life but one particular area that is often overlooked is its impact on sexual health. A significant percentage of women who survive a pelvic malignancy, including cervical cancer, develop long term sexual affects. Depending on the type of treatment administered, new sexual issues may develop during therapy, soon after completion, or even months to years later. These can include orgasmic problems and painful intercourse due to reduced vaginal size, or a lack of adequate lubrication.

What are some things women can do if sex is painful following treatment?
Women must remember that sexual problems after cancer are very common and mustn't feel ashamed or alone. It is understandably challenging to openly discuss sexual practices with healthcare providers, and so it is imperative from a physician perspective to be approachable and proactive about broaching the topic with patients. Communication is crucial for the patient as well, not only with her doctor but also with her partner. Depending on the symptom, there are many interventions that may be effective. These may be as simple as vaginal moisturizers, Kegel exercises, or referral to a specialist for a more detailed workup.

What about the emotional aspects of sex following diagnosis and treatment of a gynecologic cancer? Is loss of desire an issue?
The ramifications of cancer and its treatment on overall emotional health cannot be overestimated. The diagnosis of cancer may lead to feelings of sadness, stress in relationships, and difficulty with self esteem as one's body changes. For many women this in turn affects their sexual health. Issues such as loss of desire are commonplace and have been documented in study after study. But again, it is important to remember that there is help available as long as the communication channels are open.

What do partners need to know to best support the patient?
Often times the diagnosis and treatment of cancer is as difficult for a partner as it is for the patient. Partners should attempt to learn about the symptoms of sexual dysfunction, and understand both the physical and psychological impact cancer has had on the patient. The goal is to communicate freely so that both sides understand desires and limitations, and can therefore set realistic expectations. Open dialogue, sensitivity, and patience are of paramount importance.

Mamta Singhvi, MD, is a resident in Radiation Oncology with the UCLA Health System and a member of ASHA’s Board of Directors.