Sexual Medicine in the Management of Older Gynecologic Cancer Patients

Chapter

Abstract

Although rates of sexual activity and function have been noted to decline over time in gynecologic cancer populations, it is important not to presume that sexuality is an insignificant aspect of life for older adults. The sexual and vaginal health impact of cancer treatment can be devastating for women of all ages. Disease type, stage of disease, and type of treatment can contribute to vaginal atrophy and sexual difficulties in female cancer patients, and particular gynecologic cancer diagnoses may present their own unique challenges. Regardless of the type or extent of surgery, surgical scars are constant reminders of a woman’s cancer experience and can influence her view of herself. Unfortunately, the epidemiology of sexual dysfunction in female cancer populations has not been extensively studied, and future clinical trials focusing on age, race, ethnicity, and treatment factors are needed. Vaginal health issues are especially problematic for all women with advancing age; however, there are many simple strategies to alleviate vaginal estrogen deprivation symptoms, but this information needs to be delivered to our patients. Maintaining overall vaginal health is crucial for comfort, especially since gynecological and pelvic examinations are a necessary part of routine care and cancer ­surveillance. Despite positive changes in the oncology and sexual medicine fields over the past several decades, past several decades, there is still a paucity of targeted and a paucity of targeted interventions addressing sexual and vaginal health issues. Prospective research with uniform measures and methods are needed to fully comprehend the impact of gynecologic cancer on the sexual function and vaginal health of women of all ages coping with cancer.

Keywords

Gynecologic cancer Older adults Sexuality Vaginal health 

References

  1. 1.
    Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010;60: 277–300.PubMedGoogle Scholar
  2. 2.
    Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999;281:537–44.PubMedGoogle Scholar
  3. 3.
    Matlonis UA, Kornblith A, Lee H, et al. Long-term adjustment of early-stage ovarian cancer survivors. Int J Gynecol Cancer. 2008;18:1183–93.Google Scholar
  4. 4.
    Lindau ST, Schumm LP, Laumann EO, et al. A study of sexuality and health among older adults in the United States. N Engl J Med. 2008;357:762–74.Google Scholar
  5. 5.
    Palacios S, Castaño R, Grazziotin A. Epidemiology of female sexual dysfunction. Maturitas. 2009;63:119–23.PubMedGoogle Scholar
  6. 6.
    Carter J, Goldfrank D, Schover LR. Simple strategies for vaginal health promotion in cancer survivors. J Sex Med. 2011;8:549–59.PubMedGoogle Scholar
  7. 7.
    Schover LR. Counseling cancer patients about changes in sexual function. Oncology (Williston Park). 1999;13:1585–91; discussion 1591–2, 1595–6.Google Scholar
  8. 8.
    Katz A. Breaking the silence on cancer and sexuality: a handbook for healthcare providers. Pittsburgh: Oncology Nursing Society; 2007.Google Scholar
  9. 9.
    Onujiogu N, Johnson T, Seo S, et al. Survivors of endometrial cancer: who is at risk for sexual dysfunction? Gynecol Oncol. 2011;123:356–9.PubMedGoogle Scholar
  10. 10.
    Carter J, Raviv L, Applegarth L, et al. A cross-sectional study of the psychosocial impact of cancer-related infertility in women-Third-party reproductive assistance. J Cancer Surviv. 2010;4:236–46.PubMedGoogle Scholar
  11. 11.
    Lindau ST, Gavrilova N, Anderson D. Sexual morbidity in very long term survivors of vaginal and cervical cancer: a comparison to national norms. Gynecol Oncol. 2007;106:413–8.PubMedGoogle Scholar
  12. 12.
    Stead ML, Brown JM, Fallowfield L, et al. Lack of communication between healthcare professionals and women with ovarian cancer about sexual issues. Br J Cancer. 2003;88:666–71.PubMedGoogle Scholar
  13. 13.
    Wiggins DL, Wood R, Granai CO, et al. Sex, intimacy, and the gynecologic oncologists: ­survey results of the New England Association of Gynecologic Oncologists (NEAGO). J Psychosoc Oncol. 2007;25:61–70.PubMedGoogle Scholar
  14. 14.
    Hordern AJ, Street AF. Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs. Med J Aust. 2007;186:224–7.PubMedGoogle Scholar
  15. 15.
    Rogers M, Todd C. Information exchange in oncology outpatient clinics: source, valence and uncertainty. Psychooncology. 2002;11:336–45.PubMedGoogle Scholar
  16. 16.
    Detmar SB, Muller MJ, Schornagel JH, et al. Health-related quality-of-life assessments and patient-physician communication: a randomized controlled trial. JAMA. 2002;288:3027–34.PubMedGoogle Scholar
  17. 17.
    Carter J, Sonoda Y, Chi DS, et al. Radical trachelectomy for cervical cancer: postoperative physical and emotional adjustment concerns. Gynecol Oncol. 2008;111:151–7.PubMedGoogle Scholar
  18. 18.
    Carter J, Raviv L, Sonoda Y, et al. Recovery issues of fertility-preserving surgery in patients with early-stage cervical cancer and a model for survivorship: the physician checklist. Int J Gynecol Cancer. 2011;21:106–16.PubMedGoogle Scholar
  19. 19.
    Rutledge TL, Heckman SR, Qualls C, et al. Pelvic floor disorders and sexual function in gynecologic cancer survivors: a cohort study. Am J Obstet Gynecol. 2010;203:514.e1–7.Google Scholar
  20. 20.
    Barakat RR, Markman M, Randall ME. Principles and practice of gynecologic oncology. 5th ed. Baltimore: Lippincott, Williams & Wilkins; 2009.Google Scholar
  21. 21.
    U.S. Cancer Statistics Working Group. United States cancer statistics: 1999–2007 incidence and mortality web-based report. Atlanta: Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2010. Available at: http://www.cdc.gov/uscs.
  22. 22.
    Schover LR. Premature ovarian failure and its consequence: vasomotor symptoms, sexuality, and fertility. J Clin Oncol. 2008;26:753–8.PubMedGoogle Scholar
  23. 23.
    Hughes Jr CL, Wall LL, Creasman WT. Reproductive hormone levels in gynecologic oncology patients undergoing surgical castration after spontaneous menopause. Gynecol Oncol. 1991;40:42–5.PubMedGoogle Scholar
  24. 24.
    Finch A, Narod SA. Quality of life and health status after prophylactic salpingo-oophoretomy in women who carry a BRCA mutation: a review. Maturitas. 2011;70:261–5.PubMedGoogle Scholar
  25. 25.
    Wenzel L, Penson RT, Carter J, et al. Quality of life issues in gynecologic oncology. In: Barakat RR, Markman M, Randall ME, editors. Principles and practice of gynecologic oncology. 5th ed. Baltimore: Lippincott, Williams & Wilkins; 2009.Google Scholar
  26. 26.
    Casey C, Chen L, Rabow MW. Symptom management in gynecologic malignancies. Expert Rev Anticancer Ther. 2011;11:1077–89.PubMedGoogle Scholar
  27. 27.
    American Diabetes Association. Diabetes statistics. http://www.diabetes.org/diabetes-basics/diabetes-statistics/. Accessed October 15, 2012.
  28. 28.
    Bakhru A, Buckanovich RJ, Griggs JJ. The impact of diabetes on survival in women with ovarian cancer. Gynecol Oncol. 2011;121:106–11.PubMedGoogle Scholar
  29. 29.
    Yancik R, Havlik RJ, Wesley MN, et al. Cancer and comorbidity in older patients: a descriptive profile. Ann Epidemiol. 1996;6:399–412.PubMedGoogle Scholar
  30. 30.
    Nowosielski K, Violetta S. Mediators of sexual functions in women with diabetes. J Sex Med. 2011;8:2532–45.PubMedGoogle Scholar
  31. 31.
    Martelli V, Valisella S, Moscatiello S, et al. Prevalence of sexual dysfunction among postmenopausal women with and without metabolic syndrome. J Sex Med. 2012;9:434–41. Epub 2011 Oct 24.PubMedGoogle Scholar
  32. 32.
    Esposito K, Maiorino MI, Bellastella G, et al. Determinants of female sexual dysfunction in type 2 diabetes. Int J Impot Res. 2010;22:179–84.PubMedGoogle Scholar
  33. 33.
    Erol B, Tefekli A, Ozbey I, et al. Sexual dysfunction in type II diabetic females: a comparative study. J Sex Marital Ther. 2002;28 Suppl 1:55–62.PubMedGoogle Scholar
  34. 34.
    Rockliffe-Fidler C, Kiemle G. Sexual function in diabetic women: a psychological perspective. Sex Relat Ther. 2003;18:143–59.Google Scholar
  35. 35.
    Enzlin P, Rosen R, Wiegel M, DCCT.EDIC Research Group, et al. Sexual dysfunction in women with type 1 diabetes: long-term findings from the DCCT/EDIC study cohort. Diabetes Care. 2009;32:780–5.PubMedGoogle Scholar
  36. 36.
    Orlarinoye J, Olarinoye A. Determinants of sexual function among women with type 2 diabetes in a Nigerian population. J Sex Med. 2008;5:878–86.Google Scholar
  37. 37.
    Ogbera AO, Chinenye S, Akinlade A, et al. Frequency correlates of sexual dysfunction in women with diabetes mellitus. J Sex Med. 2009;6:3401–6.PubMedGoogle Scholar
  38. 38.
    Enzlin P, Mathieu C, Van den Bruel A, et al. Sexual dysfunction in women with type 1 diabetes: A controlled study. Diabetes Care. 2002;25:672–7.PubMedGoogle Scholar
  39. 39.
    Hughes MK. Alterations of sexual function in women with cancer. Semin Oncol Nurs. 2008;24:91–101.PubMedGoogle Scholar
  40. 40.
    Pignata S, De Placido S, Biamonte R, et al. Residual neurotoxicity in ovarian cancer patients in clinical remission after first-line chemotherapy with carboplatin and paclitaxel: the Multicenter Italian Trial in Ovarian Cancer (MITO-4) retrospective study. BMC Cancer. 2006;6:5.PubMedGoogle Scholar
  41. 41.
    Dunton CJ. Management of treatment-related toxicity in advanced ovarian cancer. Oncologist. 2002;7 Suppl 5:11–9.PubMedGoogle Scholar
  42. 42.
    Armstrong DK, Bundy B, Wenzel L, et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med. 2006;354:34–43.PubMedGoogle Scholar
  43. 43.
    Wenzel LB, Huang HQ, Armstrong DK, et al. Baseline quality of life (QOL) as a predictor of tolerance to intraperitoneal (IP) chemotherapy for advanced epithelial ovarian cancer (EOC): a Gynecologic Oncology Group (GOG) study. Paper ASCO annual meeting proceedings. J Clin Oncol. 2006;24:Abs 5007.Google Scholar
  44. 44.
    Krychman M, Pereira L, Carter J. Sexual oncology: sexual health issues in women with cancer. Oncology. 2006;71:18–25.PubMedGoogle Scholar
  45. 45.
    Kitchener H, Swart AMC, Qian W, et al. Efficacy of systemic pelvic lymphadenctomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet. 2009;373:125.PubMedGoogle Scholar
  46. 46.
    Panici PB, Basile S, Maneschi F, et al. Systematic pelvic lymphadenectomy vs no lymphadenectomy in early-stage endometrial carcinoma: ramdonized clinical trial. J Natl Cancer Inst. 2009;100:1707.Google Scholar
  47. 47.
    Walker JL, Piedmonte MR, Spirtos NM, et al. Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group study LAP2. J Clin Oncol. 2009;27:5331–6.PubMedGoogle Scholar
  48. 48.
    de Kroon CD, Gaarenstroom KN, van Poelgeest M, et al. Nerve sparing in radical surgery for early-stage cervical cancer: yes we should! Int J Gynecol Cancer. 2010;20(S2):39–41.Google Scholar
  49. 49.
    Harris PF, Remington PL, Trentham-Dietz A, Allen CI, et al. Prevalence and treatment of menopausal symptoms among breast cancer survivors. J Pain Symptom Manage. 2002;23: 501–9.PubMedGoogle Scholar
  50. 50.
    Crandall C, Petersen L, Ganz PA, et al. Association of breast cancer and its therapy with menopause-related symptoms. Menopause. 2004;11:519–30.PubMedGoogle Scholar
  51. 51.
    Gupta P, Sturdee DW, Palin SL, et al. Menopausal symptoms in women treated for breast cancer: the prevalence and severity of symptoms and their perceived effects on quality of life. Climacteric. 2006;9:49–58.PubMedGoogle Scholar
  52. 52.
    Ganz PA, Greendale GA, Petersen L, et al. Breast cancer in younger women: reproductive and late health effects of treatment. J Clin Oncol. 2003;21:4184–93.PubMedGoogle Scholar
  53. 53.
    Alektiar KM, Venkatraman E, Chi DS, et al. Intravaginal brachytherapy alone for intermediate-risk endometrial cancer. Int J Radiat Oncol Biol Phys. 2005;62:111–7.PubMedGoogle Scholar
  54. 54.
    Bergmark K, Avall-Lundqvist E, Dickman PW, et al. Vaginal changes and sexuality in women with a history of cervical cancer. N Engl J Med. 1999;340:1383–9.PubMedGoogle Scholar
  55. 55.
    Saibishkumar EP, Patel FD, Sharma SC. Evaluation of late toxicities of patients with carcinoma of the cervix treated with radical radiotherapy: an audit from India. Clin Oncol. 2006;18:30–7.Google Scholar
  56. 56.
    Flay LD, Matthews JH. The effects of radiotherapy and surgery on the sexual function of women treated for cervical cancer. Int J Radiat Oncol Biol Phys. 1995;31:399–404.PubMedGoogle Scholar
  57. 57.
    Bruner DW, Lanciano R, Keegan M, et al. Vaginal stenosis and sexual function following intracavitary radiation for the treatment of cervical and endometrial carcinoma. Int J Radiat Oncol Biol Phys. 1993;27:825–30.PubMedGoogle Scholar
  58. 58.
    Jensen P, Groenvold M, Klee M, et al. Longitudinal study of sexual function and vaginal changes after radiotherapy for cervical cancer. Int J Radiat Oncol Biol Phys. 2003;56:937–49.PubMedGoogle Scholar
  59. 59.
    Creutzberg CL, van Putten WL, Koper PC, et al. The morbidity of treatment for patients with stage I endometrial cancer: results from a randomized trial. Int J Radiat Oncol Biol Phys. 2001;51:1246–55.PubMedGoogle Scholar
  60. 60.
    Nout RA, Putter H, Jürgenliemk-Schulz IM, et al. Quality of life after pelvic radiotherapy or vaginal brachytherapy for endometrial cancer: first results of the randomized PORTEC-2 trial. J Clin Oncol. 2009;27:3547–56.PubMedGoogle Scholar
  61. 61.
    Petereit DG, Tannehill SP, Grosen EA, et al. Outpatient vaginal cuff brachytherapy for endometrial cancer. Int J Gynecol Cancer. 1999;9:456–62.PubMedGoogle Scholar
  62. 62.
    Anderson JM, Stea B, Hallum AV, et al. High-dose-rate postoperative vaginal cuff irradiation alone for stage IB and IC endometrial cancer. Int J Radiat Oncol Biol Phys. 2000;46:417–25.PubMedGoogle Scholar
  63. 63.
    MacLeod C, Fowler A, Duval P, et al. High-dose-rate brachytherapy alone post-hysterectomy for endometrial cancer. Int J Radiat Oncol Biol Phys. 1998;42:1033–9.PubMedGoogle Scholar
  64. 64.
    Kumar VJ, Nin CY, Kuei LY, et al. Survival and disease relapse in surgical stage I endometrioid adenocarcinoma of the uterus after adjuvant vaginal vault brachytherapy. Int J Gynecol Cancer. 2010;20:564–9.PubMedGoogle Scholar
  65. 65.
    Nout RA, Smit VT, Putter H, et al. Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial. Lancet. 2010;375:816–23.PubMedGoogle Scholar
  66. 66.
    Likes WM, Stegbauer C, Tillmanns T, et al. Correlates of sexual function following vulvar excision. Gynecol Oncol. 2007;105:600–3.PubMedGoogle Scholar
  67. 67.
    Burke TW, Stringer CA, Gershenson DM, et al. Radical wide excision and selective inguinal node dissection for squamous cell carcinoma of the vulva. Gynecol Oncol. 1990;38:328–32.PubMedGoogle Scholar
  68. 68.
    Berman ML, Soper JT, Creasman WT, et al. Conservative surgical management of superficially invasive stage I vulvar carcinoma. Gynecol Oncol. 1989;35:352–7.PubMedGoogle Scholar
  69. 69.
    Hacker NF, Leuchter RS, Berek JS, et al. Radical vulvectomy and bilateral inguinal lymphadenectomy through separate groin incisions. Obstet Gynecol. 1981;58:574–9.PubMedGoogle Scholar
  70. 70.
    Abu-Rustum NR, Alektiar K, Iasonos A, et al. The incidence of symptomatic lower-extremity lymphedema following treatment of uterine corpus malignancies: a 12-year experience at Memorial Sloan-Kettering Cancer Center. Gynecol Oncol. 2006;103:714–8.PubMedGoogle Scholar
  71. 71.
    Center for Disease Control and Prevention (CDC). Human papillomavirus. Rockville: National Prevention Network; 2009. www.CDC.gov/aging.
  72. 72.
    Howlader N, Noone AM, Krapcho M, Neyman N, et al. (eds.), SEER cancer statistics review, 1975–2009. Bethesda: National Cancer Institute; 2011. Available: http://seer.cancer.gov/csr/1975_2009_pops09/ Accessed on 2012.
  73. 73.
    Montgomery K, Bloch JR, Bhattacharya A. Human papillomavirus and cervical cancer knowledge, health beliefs, and preventative practices in older women. J Obstet Gynecol Neonatal Nurs. 2010;39:238–49.PubMedGoogle Scholar
  74. 74.
    Chan PK, Chang AR, Yu MY, et al. Age distribution of human papillomavirus infection and cervical neoplasia reflects caveats of cervical screening policies. Int J Cancer. 2010;26: 297–301.Google Scholar
  75. 75.
    Saslow D, Runowicz C, Solomon D, et al. American Cancer Society guideline for the early detection of cervical neoplasia and cancer. CA Cancer J Clin. 2002;52:342–62.PubMedGoogle Scholar
  76. 76.
    Jensen PT, Groenvold M, Klee MC, et al. Early-stage cervical carcinoma, radical hysterectomy, and sexual function – a longitudinal study. Cancer. 2004;100:97–106.PubMedGoogle Scholar
  77. 77.
    Pieterse QD, Maas CP, ter Kuile MM, et al. An observational longitudinal study to evaluate miction, defecation, and sexual function after radical hysterectomy with pelvic lymphadenectomy for early-stage cervical cancer. Int J Gynecol Cancer. 2006;16:1119–29.PubMedGoogle Scholar
  78. 78.
    Ditto A, Martinelli F, Borreani C, et al. Quality of life and sexual, bladder, and intestinal dysfunctions after class III nerve-sparing and class II radical hysterectomies: a questionnaire-based study. Int J Gynecol Cancer. 2009;19:953–7.PubMedGoogle Scholar
  79. 79.
    Roth AJ, Carter J, Nelson CJ. Sexuality after cancer. In: Holland JC, Breitbart WS, Jacobsen PB, et al., editors. Psycho-oncology. 2nd ed. New York: Oxford University Press, Inc.; 2010. p. 245–50.Google Scholar
  80. 80.
    Schover L, Fife M, Gershenson D. Sexual dysfunction and treatment for early stage cervical cancer. Cancer. 1989;63:204–12.PubMedGoogle Scholar
  81. 81.
    White I. The assessment and management of sexual difficulties after treatment of cervical and endometrial malignancies. Clin Oncol. 2008;20:488–96.Google Scholar
  82. 82.
    Denton AS, Maher EJ. Interventions for the physical aspects of sexual dysfunction in women following pelvic radiotherapy. Cochrane Database Syst Rev. 2003;(1):CD003750.Google Scholar
  83. 83.
    Katz A. Interventions for sexuality after pelvic radiation therapy and gynecological cancer. Cancer J. 2009;15:45–7.PubMedGoogle Scholar
  84. 84.
    Katz A, Njuguna E, Rakowsky E, et al. Early development of vaginal shortening during radiation therapy for endometrial or cervical cancer. Int J Gynecol Cancer. 2001;11:234–5.PubMedGoogle Scholar
  85. 85.
    Brand AH, Bull CA, Cakir B. Vaginal stenosis in patients treated with radiotherapy for carcinoma of the cervix. Int J Gynecol Cancer. 2006;16:288–93.PubMedGoogle Scholar
  86. 86.
    Decruze SB, Guthrie D, Magnani R. Prevention of vaginal stenosis in patients following vaginal brachytherapy. Clin Oncol. 1999;11:46–8.Google Scholar
  87. 87.
    Wenzel L, DeAlba I, Habbal R, et al. Quality of life in long-term cervical cancer survivors. Gynecol Oncol. 2005;97:310–7.PubMedGoogle Scholar
  88. 88.
    Frumovitz M, Sun CC, Schover LR, et al. Quality of life and sexual functioning in cervical cancer survivors. J Clin Oncol. 2005;23:7428–36.PubMedGoogle Scholar
  89. 89.
    Greimel ER, Winter R, Kapp KS, et al. Quality of life and sexual functioning after cervical cancer treatment: a long-term follow-up study. Psychooncology. 2009;18:476–82.PubMedGoogle Scholar
  90. 90.
    Benn T, Brooks RA, Zhang Q, et al. Pelvic exenteration in gynecologic oncology: a single institution study over 20 years. Gynecol Oncol. 2011;122:14–8.PubMedGoogle Scholar
  91. 91.
    Carter J, Chi DS, Abu-Rustum NR, et al. Brief report: Total pelvic exenteration – a retrospective clinical needs assessment. Psychooncology. 2004;13:125–31.PubMedGoogle Scholar
  92. 92.
    Maggioni A, Roviglione G, Landoni F, et al. Pelvic exenteration: ten-year experience at the European Institute of Oncology in Milan. Gynecol Oncol. 2009;114:64–8.PubMedGoogle Scholar
  93. 93.
    Pusic AL, Mehrara BJ. Vaginal reconstruction: an algorithm approach to defect classification and flap reconstruction. J Surg Oncol. 2006;94:515–21.PubMedGoogle Scholar
  94. 94.
    Cullivan R, Crown J, Walsh N. The use of psychotropic medication in patients referred to a psycho-oncology service. Psychooncology. 1998;7:301–6.PubMedGoogle Scholar
  95. 95.
    Kim HF, Fisch MJ. Antidepressant use in ambulatory cancer patients. Curr Oncol Rep. 2006;8:275–81.PubMedGoogle Scholar
  96. 96.
    Wernecke U, Northey S, Bhugra D. Antidepressants and sexual dysfunction. Acta Psychiatr Scand. 2006;114:386–97.Google Scholar
  97. 97.
    Balon R. SSRI-associated sexual dysfunction. Am J Psychiatry. 2006;163:1504–9.PubMedGoogle Scholar
  98. 98.
    Kagan SH, Holland N, Chalian AA. Sexual issues in special populations: geriatric oncology – sexuality and older adults. Semin Oncol Nurs. 2008;24:120–6.PubMedGoogle Scholar
  99. 99.
    Corney RH, Crowther ME, Everett H, et al. Psychosexual dysfunction in women with gynaecological cancer following radical pelvic surgery. Br J Obstet Gynaecol. 1993;100:73–8.PubMedGoogle Scholar
  100. 100.
    Anderson BL, Woods XA, Copeland LJ. Sexual self-schema and sexual morbidity among gynecologic cancer survivors. J Consult Clin Psychol. 1997;65:221–9.Google Scholar
  101. 101.
    Carpenter KM, Anderson BL, Fowler JM, et al. Sexual self schema as a moderator of sexual and psychological outcomes for gynecologic cancer survivors. Arch Sex Behav. 2009;38:828–41.PubMedGoogle Scholar
  102. 102.
    Lees J, Chan A. Polypharmacy in elderly patients with cancer: clinical implications and management. Lancet Oncol. 2011;12(13):1249–57. Epub 2011 Jul 6.PubMedGoogle Scholar
  103. 103.
    Labrie F, Archer D, Bouchard C, et al. Effect of intravaginal dehydroepiandrosterone (Prasterone) on libido and sexual dysfunction in postmenopausal women. Menopause. 2009;16:923–31.PubMedGoogle Scholar
  104. 104.
    North American Menopause Society. Position Statement: estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause J North Am Menopause Soc. 2010;17(2):242–55.Google Scholar
  105. 105.
    Ganz PA, Greendale GA, Kahn B, et al. Are older breast carcinoma survivors willing to take hormone replacement therapy? Cancer. 1999;86:814–20.PubMedGoogle Scholar
  106. 106.
    Biglia N, Cozzarella M, Cacciari F, et al. Menopause after breast cancer: a survey on breast cancer survivors. Maturitas. 2003;45:29–38.PubMedGoogle Scholar
  107. 107.
    van der Laak JA, de Bie LM, de Leeuw H, et al. The effect of Replens on vaginal cytology in the treatment of postmenopausal atrophy: cytomorphology versus computerised cytometry. J Clin Pathol. 2002;55:446–51.PubMedGoogle Scholar
  108. 108.
    Ekin M, Yasar L, Savan K, et al. The comparison of hyaluronic acid vaginal tablets with estradiol vaginal tablets in the treatment of atrophic vaginitis: a randomized controlled trial. Arch Gynecol Obstet. 2011;283:539–43.PubMedGoogle Scholar
  109. 109.
    Constantino D, Guaraldi C. Effectiveness and safety of vaginal suppositories for the treatment of the vaginal atrophy in postmenopausal women: an open, non-controlled clinical trial. Eur Rev Med Pharmacol Sci. 2008;12:411–6.Google Scholar
  110. 110.
    Friedman LC, Abdallah R, Schluchter M, et al. Adherence to vaginal dilation following high dose rate brachytherapy for endometrial cancer. Int J Radiat Oncol Biol Phys. 2010;80(3):751–7. Epub 2010 Jul 7.PubMedGoogle Scholar
  111. 111.
    Rosenbaum TY. Pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: a literature review. J Sex Med. 2007;4:4–13.PubMedGoogle Scholar
  112. 112.
    Goldfinger C, Pukall CF, Gentilcore-Saulnier E, et al. A prospective study of pelvic floor physical therapy: pain and psychosexual outcomes in provoked vestibulodynia. J Sex Med. 2009;6:1955–68.PubMedGoogle Scholar
  113. 113.
    Lowenstein L, Gruenwald I, Gartman I, et al. Can stronger pelvic muscle floor improve sexual function? Int Urogynecol J Pelvic Floor Dysfunct. 2010;21:553–6.Google Scholar
  114. 114.
    Groysman V. Vulvodynia: new concepts and review of the literature. Dermatol Clin. 2010;28:681–96.PubMedGoogle Scholar
  115. 115.
    Kornblith AB, Huang HQ, Walker JL, et al. Quality of life of patients with endometrial cancer undergoing laparoscopic international federation of gynecology and obstetrics staging compared with laparotomy: a Gynecologic Oncology Group study. J Clin Oncol. 2009;27:5337–42.PubMedGoogle Scholar
  116. 116.
    Baser RE, Carter J, Li Y. Psychometric validation of the Female Sexual Function Index (FSFI) in cancer survivors. Cancer. 2012;118(18):4606–18.PubMedGoogle Scholar
  117. 117.
    Isidori AM, Pozza C, Esposito K, et al. Development and validation of a 6-item version of the female sexual function index (FSFI) as a diagnostic tool for female sexual dysfunction. J Sex Med. 2010;7:1139–46.PubMedGoogle Scholar
  118. 118.
    Jeffery DD, Tzeng JP, Keefe FJ, et al. Initial report of the cancer patient-reported outcomes measurement information system (PROMIS) sexual function committee review of sexual function measures and domains used in oncology. Cancer. 2009;115:1142–53.PubMedGoogle Scholar
  119. 119.
    Flynn KE, Jeffrey DD, Keefe FJ, et al. Sexual functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS (R)). Psychooncology. 2011;20:378–86.PubMedGoogle Scholar
  120. 120.
    Flynn KE, Reese JB, Jeffrey D. Patient experiences with communication about sex during and after treatment for cancer. Psychooncology. 2012;21(6):594–601.PubMedGoogle Scholar
  121. 121.
    Goldfarb S, Abramsohn EM, Baron S, Carter J, Dickler M, Florendo J, Freeman L, Githen K, Makelarski J, Yamada SD, Lindau ST. Convening a national network to advance the field of cancer and female sexuality. Poster presentation at the cancer survivorship and sexual health symposium, Washington, D.C., June 2011.Google Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Gynecology Service, Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Survivorship DepartmentMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  3. 3.Female Sexual Medicine and Women’s Health, Department of Surgery/PsychiatryMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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