A silence full of words: sociocultural beliefs behind the sexual health of Iranian women undergoing breast cancer treatment, a qualitative study

Abstract

Purpose Therapeutic interventions lead to impaired sexual health in women undergoing breast cancer treatment. There are some problem such as vaginal dryness, decreased libido, decreased sexual satisfaction, and decreased frequency of sexual intercourse among breast cancer survivors. This study was conducted to discover the sexual experiences of women undergoing breast cancer treatment. Methods A total of 39 semi-structured interviews were held with the women undergoing breast cancer treatment, husbands, and health care providers. Recorded interviews were transcribed and analyzed using qualitative content analysis. Results Three categories of cultural and gender taboos, adherence to subjective norms, and hidden values in sexuality were revealed. The cultural and gender taboos category consisted of subcategories of learned sexual shame, fear of judgment, sexual schemas, and gender stereotypes. The adherence to subjective norms category consisted of subcategories of sexual socialization, being labeled as a disabled woman and the priority of being alive to sexuality. The hidden values in sexuality category consist of subcategories of Task-based sexuality, Tamkin, and Sexuality prevents infidelity. Conclusions Socio-cultural beliefs affect the sexual health of women undergoing breast cancer treatment, so paying attention to this issue can improve the quality of sexual health services.

The stigma in patients with breast cancer: A concept analysis

“…Because of surgery and other related treatments, BCPs would experience breast loss, surgical scar, alopecia, blackened and hardened nails, fatigue, decreased sexual desire, sexual dysfunction, and menopausal-like syndrome. 3 , 5 , 7 , 15 , 29 , 30 Patients usually believe that these symptoms destroy the identity of a traditional female, thereby affecting their external beauty and femininity, 26 damaging the normal function of the breast, reducing the hormone level, and finally, causing physiological dysfunction.…”

Nonresponse data in sexual well‐being among breast reconstruction patients—who are we overlooking?

“…Previous studies have suggested that patients with lower socioeconomic status experience more sexual dysfunction and lower sexual frequency 13,32–34 . Patients of ethnic minority backgrounds may also feel uncomfortable accessing sexual health‐related services and completing sexual health surveys due to perceived irrelevance, cultural taboo, or fear of shame and judgment 3,16,35 . Thus, despite experiencing more sexual dysfunction than their counterparts, patients who are not married and have Medicare insurances may be overlooked in clinical care and in outcomes research.…”

“…[10][11][12][13] Age and sociocultural barriers may hinder patients from freely discussing their sexual health with their providers. [14][15][16] Attitudes, experience, and interest regarding sexuality can also affect participants' willingness to partake in sexual health surveys. 17,18 Nonetheless, there is a paucity of information on missing data in sexual health surveys among breast cancer patients.…”

“…Despite the prevalence of sexual dysfunction, sexual health‐related surveys may be at a higher risk of nonresponse given the stigma and the sensitive nature of some of the questions 10–13 . Age and socio‐cultural barriers may hinder patients from freely discussing their sexual health with their providers 14–16 . Attitudes, experience, and interest regarding sexuality can also affect participants' willingness to partake in sexual health surveys 17,18 .…”

Sexual function index adaptation for breast cancer patients (FSFI-BC)- translation and psychometric properties of Persian version

“…Furthermore, in most Asian countries, including Iran, sexual issues are considered as taboo and talking about these issues is associated with feelings of shame and guilt. Health care providers are not exception, so there is not any communication about the sexual concerns between providers and patients [ 24 ]. In a study by Masjoudi et al, neglecting the sexual concerns of the survivors and the lack of teamwork among the service providers were two of the most important obstacles to talk about the sexual concerns of patients from the patient- provider communication perspective [ 25 ].…”