ReviewA systematic review of sexual concerns reported by gynecological cancer survivors
Highlights
► Literature focuses on physical sexual dysfunction in gynecologic cancer survivors. ► Women report range of sexual concerns: physical, psychological, social. ► Research should include comprehensive/systematic assessment of sexual concerns.
Section snippets
Introduction/Background
Over 76,500 new cases of gynecological cancer are diagnosed in the United States each year [1]. Treatment for gynecological cancer may cause significant physical, psychological, and social (or interpersonal) side effects that can interfere with a woman's sexuality [2], [3]. Investigators report that between 30-100% of gynecological cancer survivors experience some form of physical sexual dysfunction [for reviews see [4], [5], [6], [7]]. Female sexual dysfunction is characterized by decreased
Method
A systematic review of literature was conducted to answer the question, “What are the physical, psychological and social concerns that GYN cancer survivors experience related to their sexuality; including, but not limited to, sexual dysfunction?” The first author (KAA) searched CINAHL, PubMed, PsycInfo, and Google Scholar databases through August 2011. No date limitation was set: the earliest date covered in the database was 1948. The following terms were used in various combinations: GYN*,
Results
Over 1000 research articles were located that addressed a broad range of themes related to sexuality in cancer patients. A total of 37 articles met our inclusion criteria, with publication dates from 1988 to 2011. Thirty-four studies explored sexual concerns following gynecological cancer diagnosis and treatment, and three studies investigated effects of interventions designed to address sexual concerns in women with a variety of gynecological cancer diagnoses. Table 1 provides information
Discussion
Of the 34 studies reviewed to identify sexual concerns, all but one identified physical sexual concerns. In that one study, participants were asked to discuss how treatment affected their sexuality and the relationship with their partner, but no physical sexual concerns were raised [35]. A total of 16 physical concerns were identified in this review. The scope of physical sexual concerns encompassed effects from structural changes and changes in hormonal status. Dyspareunia was commonly
Conclusion
This review provided evidence that gynecological cancer survivors experience sexual concerns across physical, psychological and social dimensions of sexuality; but it appears that physical sexual concerns have received greater attention than psychological and social concerns. More research is needed that includes comprehensive and systematic assessment of sexual concerns, using reliable and valid measures in large representative samples that include all gynecologic cancer diagnoses, stages of
Conflict of interest statement
All authors declare that they have no conflicts of interest regarding this manuscript.
Acknowledgements
This work is supported in part by the Doctoral Degree Scholarship in Cancer Nursing #121325-DSCN-11-209-01-SCN from the American Cancer Society and the Gwen Shapiro Wisconsin Distinguished Doctoral fellowship. The authors would like to thank Rebecca J. Muehrer, PhD, RN, Sandra Ward, PhD, RN, FAAN, and the Kwekkeboom Research Group for their review and feedback on earlier versions of the manuscript.
References (65)
- et al.
Sexual function after gynecologic cancer
Obstet Gynecol Clin North Am
(2006 Dec) - et al.
The sexual health of women after gynecological malignancy
J Midwifery Womens Health
(Jul/Aug 2010) Sexuality: A quality of life issue for cancer survivors
Semin Oncol Nurs
(2008 May)Sexuality: A critical component of quality of life in chronic disease
Nurs Clin N Am
(2007)- et al.
Sexual implications of gynecological cancer treatments
J Obstet Gynecol Nurs
(2000 July) - et al.
Sexuality and intimacy after gynecological cancer
Maturitas
(2010) - et al.
Delivering sensitive health care information: Challenging the taboo of women's sexual health after pelvic radiotherapy
Patient Educ Couns
(2008) - et al.
Sexual dysfunction in patients with gynecologic neoplasms: A retrospective pilot study
J Sex Med
(Jul 2006) - et al.
A controlled study of sexual activity and functioning in epithelial ovarian cancer survivors: A therapeutic approach
Gynecol Oncol
(Feb 2008) - et al.
Sexual morbidity in very long term survivors of vaginal and cervical cancer: A comparison to national norms
Gynecol Oncol
(Aug 2007)
Sexuality among gynecologic cancer patients-A cross-sectional study
Gynecol Oncol
Quality of life and sexual function in gynecological cancer patients: Results from quantitative and qualitative data
Eur J Oncol Nurs
Psychosexual function and impact of gynecological cancer
Best Pract Res Clin Obstet
Sexual health in women treated for cervical cancer: Characteristics and correlates
Gynecol Oncol
Sexual dysfunction following vulvectomy
Gynecol Oncol
Basic information about gynecologic cancers
The importance of assessing sexuality: A patient perspective
Clin J Oncol Nurs
Assessing women's sexuality after cancer therapy: Checking assumptions with the focus group technique
Cancer Nurs
Psychological interventions for the sexual sequelae of cancer: A review of the literature
J Cancer Surviv
Sexuality, intimacy, and gynecological cancer
J Sex Marital Ther
Female cancer survivors: Appreciating their sexual concerns
Can J Hum Sex
Definition of sexuality and sexual health [Internet]
Toward a holistic perspective of human sexuality: Alterations in sexual health and nursing diagnosis
Holist Nurs Pract
Theoretical issues in studying sexuality in close relationships
Issues of intimacy and sexuality in the face of cancer: The patient perspective
Cancer Nurs
Biopsychosocial models of women's sexual response: Appreciation to management of desire disorders
Sexual and Relationship Therapy
Psychosexual function and impact of gynaecological cancer
Best Pract Res Clin Obstet
Evaluation of sexual function in patients with gynecologic cancer and evidence-based nursing interventions
Sex Disabil
Acute symptom management
Invasive Cervical Cancer
Sexuality and cancer: The final frontier for nurses
Oncol Nurs Forum
Promotion of sexual health: Recommendations for action
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