Skip to main content
Erschienen in: Journal für Gynäkologische Endokrinologie/Österreich 4/2023

14.11.2023 | Originalien

Krebserkrankungen und deren Auswirkungen auf die weibliche Sexualität – eine Übersicht mit Fallbeispielen

verfasst von: PD Dr. med. Désirée Louise Dräger, M. A., Julia Nolting, Oliver Hakenberg

Erschienen in: Gynäkologie in der Praxis | Ausgabe 4/2023

Einloggen, um Zugang zu erhalten

Zusammenfassung

Ein äußerst wichtiger und oft vernachlässigter Aspekt der Krebsbehandlung ist die Sexualität. Sexualität ist von Natur aus ein menschliches Bedürfnis, dies hört auch nach einer Krebsdiagnose nicht auf. Sexualität umfasst mehrere Domänen, und alle sind durch eine Krebserkrankung und deren Behandlung gefährdet. Trotz der Bedeutung der sexuellen Gesundheit stellt diese immer noch ein selten beachtetes Bedürfnis dar. Veränderungen der Sexualität und des sexuellen Wohlbefindens sind negative Langzeitfolgen von Krebs und Krebsbehandlungen. Diese Veränderungen können sich auch negativ auf das psychische Wohlbefinden, die Lebensqualität und die Paarbeziehung auswirken. Ärzte sollten zu jedem Zeitpunkt der Krebsbehandlung (Diagnose, Behandlung, Nachsorge) nach sexuellen Gesundheitsproblemen fragen, v. a. bei Frauen.
Literatur
2.
Zurück zum Zitat Taylor J et al (2020) Sexual health toxicity in cancer survivors: is there a gender disparity in physician evaluation and intervention? Int J Radiat Oncol Biol Phys 108:S136CrossRef Taylor J et al (2020) Sexual health toxicity in cancer survivors: is there a gender disparity in physician evaluation and intervention? Int J Radiat Oncol Biol Phys 108:S136CrossRef
3.
4.
Zurück zum Zitat Ussher J, al at (2015) Perceived causes and consequences of sexual changes after cancer for women and men: a mixed method study. BMC Cancer 15:268PubMedPubMedCentralCrossRef Ussher J, al at (2015) Perceived causes and consequences of sexual changes after cancer for women and men: a mixed method study. BMC Cancer 15:268PubMedPubMedCentralCrossRef
5.
Zurück zum Zitat Hodges LJ et al (2005) A meta-analytic investigation of the relationship between the psychological distress of cancer patients and their carers. Soc Sci Med 60(1):1–12PubMedCrossRef Hodges LJ et al (2005) A meta-analytic investigation of the relationship between the psychological distress of cancer patients and their carers. Soc Sci Med 60(1):1–12PubMedCrossRef
6.
Zurück zum Zitat World Health Organisation (1995) The world health organisation quality of life assessment (whoqol) position paper. Soc Sci Med 41:1403–1409CrossRef World Health Organisation (1995) The world health organisation quality of life assessment (whoqol) position paper. Soc Sci Med 41:1403–1409CrossRef
7.
Zurück zum Zitat Arrington R et al (2004) Questionnaires to measure sexual quality of life. Qual Life Res 13(10):1643–1658PubMedCrossRef Arrington R et al (2004) Questionnaires to measure sexual quality of life. Qual Life Res 13(10):1643–1658PubMedCrossRef
8.
Zurück zum Zitat Anderson BL et al (2000) Sexual self-concept for the women with cancer. Cancer and the family. John Wiley & Sons Anderson BL et al (2000) Sexual self-concept for the women with cancer. Cancer and the family. John Wiley & Sons
9.
Zurück zum Zitat De Groot JM et al (2005) The psychosocial impact of cervical cancer among affected women and their partners. Int J Gynecol Cancer 15:918–925PubMedCrossRef De Groot JM et al (2005) The psychosocial impact of cervical cancer among affected women and their partners. Int J Gynecol Cancer 15:918–925PubMedCrossRef
10.
Zurück zum Zitat Bertero C et al (2007) Breast cancer diagnosis and its treatment affecting the self. Cancer Nurs 30(3):194–202PubMedCrossRef Bertero C et al (2007) Breast cancer diagnosis and its treatment affecting the self. Cancer Nurs 30(3):194–202PubMedCrossRef
12.
Zurück zum Zitat Gilbert E et al (2010) Sexuality after breast cancer: a review. Maturitas 66:397–407PubMedCrossRef Gilbert E et al (2010) Sexuality after breast cancer: a review. Maturitas 66:397–407PubMedCrossRef
13.
Zurück zum Zitat Gilbert E et al (2011) Sexuality after gynaecological cancer: a review of the material, intrapsychic, and discursive aspects of treatment on women’s sexual-wellbeing. Maturitas 70(1):42–57PubMedCrossRef Gilbert E et al (2011) Sexuality after gynaecological cancer: a review of the material, intrapsychic, and discursive aspects of treatment on women’s sexual-wellbeing. Maturitas 70(1):42–57PubMedCrossRef
14.
Zurück zum Zitat Carter J et al (2013) The physical consequences of gynecologic cancer surgery and their impact on sexual, emotional, and quality of life issues. J Sex Med 10:21–34PubMedCrossRef Carter J et al (2013) The physical consequences of gynecologic cancer surgery and their impact on sexual, emotional, and quality of life issues. J Sex Med 10:21–34PubMedCrossRef
15.
Zurück zum Zitat Basson R (2010) Sexual function of women with chronic illness and cancer. Womens Health 6(3):407–429 Basson R (2010) Sexual function of women with chronic illness and cancer. Womens Health 6(3):407–429
16.
Zurück zum Zitat Holmes L (2005) Sexuality in gynaecological cancer patients. Cancer Nurs Pract 4(6):35–39CrossRef Holmes L (2005) Sexuality in gynaecological cancer patients. Cancer Nurs Pract 4(6):35–39CrossRef
17.
Zurück zum Zitat Ussher JM et al (2012) Changes to sexual well-being and intimacy after breast cancer. Cancer Nurs 35(6):456–464PubMedCrossRef Ussher JM et al (2012) Changes to sexual well-being and intimacy after breast cancer. Cancer Nurs 35(6):456–464PubMedCrossRef
18.
Zurück zum Zitat Bergmark K et al (1999) Vaginal changes and sexuality in women with a history of cervical cancer. N Engl J Med 340(18):1383–1389PubMedCrossRef Bergmark K et al (1999) Vaginal changes and sexuality in women with a history of cervical cancer. N Engl J Med 340(18):1383–1389PubMedCrossRef
19.
Zurück zum Zitat Safarinejad MR et al (2013) Quality of life and sexual functioning in young women with early stage breast cancer 1 year after lumpectomy. Psychooncology 22(6):1242–1248PubMedCrossRef Safarinejad MR et al (2013) Quality of life and sexual functioning in young women with early stage breast cancer 1 year after lumpectomy. Psychooncology 22(6):1242–1248PubMedCrossRef
20.
Zurück zum Zitat Stead ML et al (2007) Psychosexual function and impact of gynaecological cancer. Best Pract Res Clin Obstet Gynaecol 21(2):309–320PubMedCrossRef Stead ML et al (2007) Psychosexual function and impact of gynaecological cancer. Best Pract Res Clin Obstet Gynaecol 21(2):309–320PubMedCrossRef
21.
Zurück zum Zitat Lamb MA et al (1994) The sexual adaptation of women treated for endometrial cancer. Cancer Pract 2(2):103–113PubMed Lamb MA et al (1994) The sexual adaptation of women treated for endometrial cancer. Cancer Pract 2(2):103–113PubMed
22.
Zurück zum Zitat Plotti F et al (2011) Quality of life and sexual function after type C2/type III radical hysterectomy for locally advanced cervical cancer: a prospective study. J Sex Med 8(3):894–904PubMedCrossRef Plotti F et al (2011) Quality of life and sexual function after type C2/type III radical hysterectomy for locally advanced cervical cancer: a prospective study. J Sex Med 8(3):894–904PubMedCrossRef
23.
Zurück zum Zitat Fobair P et al (2006) Body image and sexual problems in young women with breast cancer. Psychooncology 15(7):579–594PubMedCrossRef Fobair P et al (2006) Body image and sexual problems in young women with breast cancer. Psychooncology 15(7):579–594PubMedCrossRef
24.
Zurück zum Zitat Archibald S et al (2006) Chemically-induced menopause and the sexual functioning of breast cancer survivors. Women Ther 29(1/2):83–106CrossRef Archibald S et al (2006) Chemically-induced menopause and the sexual functioning of breast cancer survivors. Women Ther 29(1/2):83–106CrossRef
25.
Zurück zum Zitat Wilmoth MC (2001) The aftermath of breast cancer: an altered sexual self. Cancer Nurs 24(4):278–286PubMedCrossRef Wilmoth MC (2001) The aftermath of breast cancer: an altered sexual self. Cancer Nurs 24(4):278–286PubMedCrossRef
26.
Zurück zum Zitat Green MS et al (2000) Sexual dysfunction following vulvectomy. Gynecol Oncol 77(1):73–77PubMedCrossRef Green MS et al (2000) Sexual dysfunction following vulvectomy. Gynecol Oncol 77(1):73–77PubMedCrossRef
27.
Zurück zum Zitat Meyerowitz B et al (1999) Sexuality following breast cancer. J Sex Marital Ther 25:237–250PubMedCrossRef Meyerowitz B et al (1999) Sexuality following breast cancer. J Sex Marital Ther 25:237–250PubMedCrossRef
28.
Zurück zum Zitat Juraskova I et al (2013) Sexual adjustment following early stage cervical and endometrial cancer: prospective controlled multi-centre study. Psychooncology 22(1):153–159PubMedCrossRef Juraskova I et al (2013) Sexual adjustment following early stage cervical and endometrial cancer: prospective controlled multi-centre study. Psychooncology 22(1):153–159PubMedCrossRef
29.
Zurück zum Zitat Milbury K et al (2013) The association between psychosocial and medical factors with long-term sexual dysfunction after treatment for colorectal cancer. Support Care Cancer 21(3):793–802PubMedCrossRef Milbury K et al (2013) The association between psychosocial and medical factors with long-term sexual dysfunction after treatment for colorectal cancer. Support Care Cancer 21(3):793–802PubMedCrossRef
30.
Zurück zum Zitat Traa MJ et al (2012) Sexual (dys)function and the quality of sexual life in patients with colorectal cancer: a systematic review. Ann Oncol 23(1):19–27PubMedCrossRef Traa MJ et al (2012) Sexual (dys)function and the quality of sexual life in patients with colorectal cancer: a systematic review. Ann Oncol 23(1):19–27PubMedCrossRef
31.
Zurück zum Zitat Donovan KA et al (2010) Sexual function in colorectal cancer survivors. Cancer Control 17(1):44–51PubMedCrossRef Donovan KA et al (2010) Sexual function in colorectal cancer survivors. Cancer Control 17(1):44–51PubMedCrossRef
32.
Zurück zum Zitat van der Horst-Schrivers ANA et al (2009) Sexual function in patients with metastatic midgut carcinoid tumours. Neuroendocrinology 89(2):231–236PubMedCrossRef van der Horst-Schrivers ANA et al (2009) Sexual function in patients with metastatic midgut carcinoid tumours. Neuroendocrinology 89(2):231–236PubMedCrossRef
33.
Zurück zum Zitat Low C et al (2009) Issues of intimacy and sexual dysfunction following major head and neck cancer treatment. Oral Oncol 45(10):898–903PubMedCrossRef Low C et al (2009) Issues of intimacy and sexual dysfunction following major head and neck cancer treatment. Oral Oncol 45(10):898–903PubMedCrossRef
34.
Zurück zum Zitat Monga U et al (1997) Sexuality in head and neck cancer patients. Arch Phys Med Rehabil 78(3):298–304PubMedCrossRef Monga U et al (1997) Sexuality in head and neck cancer patients. Arch Phys Med Rehabil 78(3):298–304PubMedCrossRef
35.
Zurück zum Zitat Salem HK (2007) Radical cystectomy with preservation of sexual function and fertility in patients with transitional cell carcinoma of the bladder: new technique. Int J Urol 14:294–298PubMedCrossRef Salem HK (2007) Radical cystectomy with preservation of sexual function and fertility in patients with transitional cell carcinoma of the bladder: new technique. Int J Urol 14:294–298PubMedCrossRef
36.
Zurück zum Zitat Jonker-Pool G et al (2004) Male sexuality after cancer treatment-needs for information and support: testicular cancer compared to malignant lymphoma. Patient Educ Couns 52(2):143–150PubMedCrossRef Jonker-Pool G et al (2004) Male sexuality after cancer treatment-needs for information and support: testicular cancer compared to malignant lymphoma. Patient Educ Couns 52(2):143–150PubMedCrossRef
37.
Zurück zum Zitat Jarden M et al (2012) The impact of hematopoietic stem cell transplantation on sexuality: a systematic review of the literature. Bone Marrow Transplant 47:716PubMedCrossRef Jarden M et al (2012) The impact of hematopoietic stem cell transplantation on sexuality: a systematic review of the literature. Bone Marrow Transplant 47:716PubMedCrossRef
38.
Zurück zum Zitat Shell JA et al (2008) The longitudinal effects of cancer treatment on sexuality in individuals with lung cancer. Oncol Nurs Forum 35(1):73–79PubMedCrossRef Shell JA et al (2008) The longitudinal effects of cancer treatment on sexuality in individuals with lung cancer. Oncol Nurs Forum 35(1):73–79PubMedCrossRef
39.
Zurück zum Zitat Galbraith ME et al (2008) Alterations of sexual function in men with cancer. Semin Oncol Nurs 24(2):102–114PubMedCrossRef Galbraith ME et al (2008) Alterations of sexual function in men with cancer. Semin Oncol Nurs 24(2):102–114PubMedCrossRef
40.
Zurück zum Zitat Greenfield DM et al (2010) Quality of life, self-esteem, fatigue, and sexual function in young men after cancer: a controlled cross-sectional study. Cancer 116(6):1592–1601PubMedCrossRef Greenfield DM et al (2010) Quality of life, self-esteem, fatigue, and sexual function in young men after cancer: a controlled cross-sectional study. Cancer 116(6):1592–1601PubMedCrossRef
41.
Zurück zum Zitat Bober SL et al (2013) Sexual function in childhood cancer survivors: a report from project REACH. J Sex Med 10(8):2084–2093PubMedCrossRef Bober SL et al (2013) Sexual function in childhood cancer survivors: a report from project REACH. J Sex Med 10(8):2084–2093PubMedCrossRef
43.
Zurück zum Zitat Australian Institute of Health and Welfare (2014) Cancer in Australia: an overview 2014. AIHW, Canberra Australian Institute of Health and Welfare (2014) Cancer in Australia: an overview 2014. AIHW, Canberra
44.
Zurück zum Zitat Mercadante S et al (2010) Sexual issues in early and late stage cancer: a review. Support Care Cancer 18(6):659–665PubMedCrossRef Mercadante S et al (2010) Sexual issues in early and late stage cancer: a review. Support Care Cancer 18(6):659–665PubMedCrossRef
45.
Zurück zum Zitat Frumovitz M et al (2005) Quality of life and sexual functioning in cervical cancer survivors. J Clin Oncol 23(30):7428–7436PubMedCrossRef Frumovitz M et al (2005) Quality of life and sexual functioning in cervical cancer survivors. J Clin Oncol 23(30):7428–7436PubMedCrossRef
46.
Zurück zum Zitat Kim KR et al (2012) Body image, sexual function and depression in Korean patients with breast cancer: modification by 5‑HTT polymorphism. Support Care Cancer 20(9):2177–2182PubMedCrossRef Kim KR et al (2012) Body image, sexual function and depression in Korean patients with breast cancer: modification by 5‑HTT polymorphism. Support Care Cancer 20(9):2177–2182PubMedCrossRef
47.
Zurück zum Zitat Den Oudsten B et al (2010) Clinical factors are not the best predictors of quality of sexual life and sexual functioning in women with early stage breast cancer. Psychooncology 19:646–656CrossRef Den Oudsten B et al (2010) Clinical factors are not the best predictors of quality of sexual life and sexual functioning in women with early stage breast cancer. Psychooncology 19:646–656CrossRef
48.
Zurück zum Zitat Rouanne M et al (2013) Evaluation of sexuality, health-related quality-of-life and depression in advanced cancer patients: a prospective study in a Phase I clinical trial unit of predominantly targeted anticancer drugs. Eur J Cancer 49(2):431–438PubMedCrossRef Rouanne M et al (2013) Evaluation of sexuality, health-related quality-of-life and depression in advanced cancer patients: a prospective study in a Phase I clinical trial unit of predominantly targeted anticancer drugs. Eur J Cancer 49(2):431–438PubMedCrossRef
49.
Zurück zum Zitat Biglia N et al (2010) Effects of surgical and adjuvant therapies for breast cancer on sexuality, cognitive functions, and body weight. J Sex Med 7(5):1891–1900PubMedCrossRef Biglia N et al (2010) Effects of surgical and adjuvant therapies for breast cancer on sexuality, cognitive functions, and body weight. J Sex Med 7(5):1891–1900PubMedCrossRef
50.
Zurück zum Zitat Orsini RG et al (2013) Quality of life of older rectal cancer patients is not impaired by a permanent stoma. Eur J Surg Oncol 39(2):164–170PubMedCrossRef Orsini RG et al (2013) Quality of life of older rectal cancer patients is not impaired by a permanent stoma. Eur J Surg Oncol 39(2):164–170PubMedCrossRef
51.
Zurück zum Zitat Grant M et al (2011) Gender differences in quality of life among long-term colorectal cancer survivors with ostomies. Oncol Nurs Forum 38(5):587–596PubMedPubMedCentralCrossRef Grant M et al (2011) Gender differences in quality of life among long-term colorectal cancer survivors with ostomies. Oncol Nurs Forum 38(5):587–596PubMedPubMedCentralCrossRef
52.
Zurück zum Zitat Traa MJ et al (2014) Measuring the health-related quality of life and sexual functioning of patients with rectal cancer: Does type of treatment matter? Int J Cancer 134(4):979–987PubMedCrossRef Traa MJ et al (2014) Measuring the health-related quality of life and sexual functioning of patients with rectal cancer: Does type of treatment matter? Int J Cancer 134(4):979–987PubMedCrossRef
53.
Zurück zum Zitat Kleinplatz PJ (2012) New directions in sex therapy: Innovations and alternatives, 2. Aufl. Brunner-Routledge, PhiladelphiaCrossRef Kleinplatz PJ (2012) New directions in sex therapy: Innovations and alternatives, 2. Aufl. Brunner-Routledge, PhiladelphiaCrossRef
54.
Zurück zum Zitat Alder J et al (2008) Sexual dysfunction after premenopausal stage I and II breast cancer: Do androgens play a role? J Sex Med 5:1898–1906PubMedCrossRef Alder J et al (2008) Sexual dysfunction after premenopausal stage I and II breast cancer: Do androgens play a role? J Sex Med 5:1898–1906PubMedCrossRef
55.
Zurück zum Zitat Manne S et al (2006) Cancer-related relationship communication in couples with early stage breast cancer. Psychooncology 15(3):234–247PubMedCrossRef Manne S et al (2006) Cancer-related relationship communication in couples with early stage breast cancer. Psychooncology 15(3):234–247PubMedCrossRef
56.
Zurück zum Zitat Badr H et al (2008) Does talking about their relationship affect couples’ marital and psychological adjustment to lung cancer? J Cancer Surviv 2(1):53–64PubMedCrossRef Badr H et al (2008) Does talking about their relationship affect couples’ marital and psychological adjustment to lung cancer? J Cancer Surviv 2(1):53–64PubMedCrossRef
57.
Zurück zum Zitat Zunkel G (2002) Relational coping processes: couples’ response to a diagnosis of early stage breast cancer. J Psychosoc Oncol 20(4):39–55PubMedCrossRef Zunkel G (2002) Relational coping processes: couples’ response to a diagnosis of early stage breast cancer. J Psychosoc Oncol 20(4):39–55PubMedCrossRef
58.
Zurück zum Zitat Kayser K et al (2007) Cancer as a ‚we-disease‘: examining the process of coping from a relational perspective. Fam Syst Health 25(4):404–418CrossRef Kayser K et al (2007) Cancer as a ‚we-disease‘: examining the process of coping from a relational perspective. Fam Syst Health 25(4):404–418CrossRef
59.
Zurück zum Zitat Manne S et al (2004) Posttraumatic growth after breast cancer: patient, partner, and couple perspectives. Psychosom Med 66(3):442–454PubMed Manne S et al (2004) Posttraumatic growth after breast cancer: patient, partner, and couple perspectives. Psychosom Med 66(3):442–454PubMed
60.
Zurück zum Zitat Kuijer RG et al (2000) Active engagement, protective buffering and overprotection: three ways of giving support by intimate partners of patients with cancer. J Soc Clin Psychol 19(2):256–275CrossRef Kuijer RG et al (2000) Active engagement, protective buffering and overprotection: three ways of giving support by intimate partners of patients with cancer. J Soc Clin Psychol 19(2):256–275CrossRef
61.
Zurück zum Zitat Badr H et al (2006) Social constraints and spousal communication in lung cancer. Psychooncology 15(8):673–683PubMedCrossRef Badr H et al (2006) Social constraints and spousal communication in lung cancer. Psychooncology 15(8):673–683PubMedCrossRef
62.
Zurück zum Zitat Jack DC (1991) Silencing the self: Women and depression. Harvard University Press, Cambridge Jack DC (1991) Silencing the self: Women and depression. Harvard University Press, Cambridge
63.
Zurück zum Zitat Whiffen VE et al (2007) Self-silencing mediates the link between marital conflict and depression. J Soc Pers Relat 24(6):993–1006CrossRef Whiffen VE et al (2007) Self-silencing mediates the link between marital conflict and depression. J Soc Pers Relat 24(6):993–1006CrossRef
Metadaten
Titel
Krebserkrankungen und deren Auswirkungen auf die weibliche Sexualität – eine Übersicht mit Fallbeispielen
verfasst von
PD Dr. med. Désirée Louise Dräger, M. A.
Julia Nolting
Oliver Hakenberg
Publikationsdatum
14.11.2023
Verlag
Springer Vienna
Erschienen in
Gynäkologie in der Praxis / Ausgabe 4/2023
Print ISSN: 3005-0758
Elektronische ISSN: 3005-0766
DOI
https://doi.org/10.1007/s41974-023-00292-9

Weitere Artikel der Ausgabe 4/2023

Journal für Gynäkologische Endokrinologie/Österreich 4/2023 Zur Ausgabe

One Minute Wonder

PCOS in der Adoleszenz

News-Screen Assistierte Reproduktion

News-Screen Assistierte Reproduktion

Mitteilungen der Österreichischen IVF-Gesellschaft

Mitteilungen der Österreichischen IVF-Gesellschaft

News-Screen Menopause

Trockene Augen