Assessment of sexual activity and dysfunction in medically underserved women with gynecologic cancers

Abstract

Background Sexual dysfunction is a common long-term side effect of treatments for gynecologic cancer. Studies of sexual problems in gynecologic cancer survivors overrepresent White non-Hispanic, highly educated, and married women. Less is known about the sexual health needs of women in medically underserved populations. We therefore conducted a study to characterize sexual activity and sexual function in this population. Methods We recruited patients attending two gynecologic oncology clinics in a large public healthcare system that primarily serves uninsured and low-income patients. Participants were invited to complete a one-time survey to assess sexual function, sexual communication, sexual distress, relationship adjustment, depression, anxiety, prior help-seeking and help-seeking preferences, and reasons for sexual inactivity. Data were analyzed using descriptive statistics and multivariate models to predict sexual activity status and sexual dysfunction. Results Among 243 participants, the majority (n=160, 65.8%) were not sexually active in the past 4 weeks, most often due to lack of a partner or lack of desire for sex. Just over one-fourth of sexually active participants were identified as likely cases of sexual dysfunction. Greater endorsement of depressive symptoms predicted both sexual inactivity and sexual dysfunction in multivariate analyses. Prior help-seeking for sexual problems was uncommon; however, a significant minority of participants expressed interest in receiving care for sexual problems. Conclusions Gynecologic cancer survivors in our medically underserved population have high rates of sexual inactivity and sexual dysfunction. Future research should identify feasible strategies to address barriers to sexual health care in low-resource settings.

Sexual health of endometrial cancer survivors before and after a physical activity intervention: A retrospective cohort analysis

“…Researchers have identified risk factors for poor sexual health of women, particularly ECS (5, 6, 9-11, 32-34). In our study, survivors with lower baseline sexual health had lower educational attainment, which aligns with findings from the general female population (33) and ECS (34).…”

“…Therefore, future studies should include sexuality-based questionnaires to obtain robust information about cancer survivor sexuality (39). Other authors recommend the development of questionnaires that would better account for the lack of or limited sexual activity within the cancer survivor population (32). Moving forward, our results provide the foundation for future studies to employ exercise interventions with high-quality sexual health assessments to further investigate the impact of exercise and other factors that mediate changes in sexual health.…”

Evaluating Sexual Satisfaction and Quality of Life in Patients with Gynecological Cancer

“…Sexual satisfaction is defined as the level of happiness and pleasure of an individual's sexual relations and is determined by the sexual and non sexual aspects of the relationship. Sexuality is an integral element of human life and has been identified as an important QoL component (6,7,8). There are a variety of factors that affect individual sexual satisfaction such as social relationships, general conditions, the gender, age, the cultural environment, and physical and mental health (9).…”

Comparação da disfunção do assoalho pélvico com função sexual e qualidade de vida em sobreviventes ao câncer ginecológico

“…Importante destacar que cerca de 44% das participantes do estudo tornaram-se inativas sexualmente após o tratamento oncológico, ressaltando que essas mulheres inativas não responderam o questionário de função sexual. Bradford et al (2015) observaram uma taxa de inatividade sexual de 65,8% em um estudo que avaliou a atividade sexual e a função sexual de 243 sobreviventes ao câncer ginecológico, e relataram como principais preditores de inatividade, a ausência do parceiro, o estágio da doença e o tipo de tratamento realizado. Apesar do conhecimento de tais preditores, no presente estudo não foi avaliado o motivo da inatividade sexual das participantes.…”

“…As disfunções do assoalho pélvico são tópicos importantes abordados nas complicações pós-tratamento do câncer ginecológico (YE et al, 2014), sendo as queixas mais relatadas pelas mulheres o baixo desejo sexual, secura e alterações anatômicas da região vaginal, anorgasmia e dispareunia (BRADFORD et al, 2015). Ao exame objetivo, a disfunção mais frequente é a estenose vaginal (YOSHIDA et al, 2015), relacionada à diminuição da largura e elasticidade da mucosa vaginal, provocando dor e desconforto durante a atividade sexual (CARTER et al, 2017) e dificultando a realização de exames ginecológicos de rotina, indispensáveis no seguimento clínico dessas mulheres (SILVA et al, 2010;ROS;ESPUNA, 2013).…”