Sexual dysfunction in men and women after treatment for cancer is one of the most common problems of survivorship, yet most survivors experiencing sexual dysfunction do not receive medical help. Left untreated, sexual dysfunction does not resolve, but instead persists over many years. Not all survivors are distressed about sexual dysfunction. Factors associated with distress include young age, being in a relationship, and having enjoyed sexuality before the cancer diagnosis. The most common problem for which men seek help is erectile dysfunction, although loss of desire for sex, difficulty reaching orgasm, and pain during sexual activity also occur after a number of treatments. Pelvic surgery and radiation are common causes of erectile dysfunction, but hypogonadism also sometimes occurs in survivors of intensive chemotherapy. In women, chemotherapy-induced ovarian failure is a major risk factor for vaginal dryness, dyspareunia, and consequent loss of interest in sex. Pelvic radiation therapy, surgery that changes vaginal or vulvar anatomy, or vaginal complications of graft-versus-host disease are also problematic. Oncology clinics should provide basic education, counseling, and referrals. The optimal treatment for sexual dysfunction is multidisciplinary, with a medical specialist and a mental health professional working together to assess the problem and create a treatment plan.
KeywordsErectile Dysfunction Sexual Function Sexual Dysfunction Sexual Arousal Radical Cystectomy
- Rechis R, Boerner L. How cancer has affected post-treatment survivors: a Livestrong report, June 2010. http://www.livestrong.org/What-We-Do/Our-Approach/Reports-Findings/LIVESTRONG-Survey-Report. Accessed November 5, 2013.
- Rowland JH, Mariotto A, Alfano CM, Pollack LA, Weir HK, White A. Cancer Survivors—United States, 2007. MMWR 2011;60:269–272.Google Scholar
- Schover LR. Reduction of psychosexual dysfunction in cancer patients. In: Miller SM, Bowen DJ, Croyle RT, Rowland, JH, eds. Handbook of Cancer Control and Behavioral Science. Washington, DC: American Psychological Association Press; 2008b:379–390.Google Scholar
- Schover LR, Ying Y, Fellman BM, Odensky E, Lewis PE, Martinetti P. Efficacy trial of an internet-based intervention for cancer-related female sexual dysfunction. J Natl Comp Cancer Network 2013;in press.Google Scholar
- Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev 2006;4:CD001500.Google Scholar