Assessment of sexuality in longterm survivors with ovarian cancer

Rolf, C; Woopen, Hannah; Richter, Ralf P.; Sehouli, A Pirmorady; Braicu, EI; Schnuppe, K; Sehouli, Jalid

doi:10.1055/s-0038-1671329

Cited by 5 publications

(9 citation statements)

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“… 20 Dyspareunia affected up to 77% of women with ovarian cancer, 19 worsening from diagnosis 24 25 and with longer survival. 12 21 Although one study (n=47) found menopausal symptoms comparable between women with ovarian cancer and healthy women, 23 women who had undergone pre-menopausal oophorectomy were found to have higher levels of sexual discomfort (p<0.001). 16 Similarly, greater sexual discomfort in sexually active women with ovarian cancer was associated with both lower serum levels of estradiol (p=0.02) and higher levels of sex hormone binding globulin (p=0.04).…”

Section: Resultsmentioning

confidence: 93%

“…Only five of the 29 studies (17.2%) used healthy control groups. [12][13][14][15][16] With such a lack of comparison groups, quantifying how much psychosexual morbidity is directly attributable to epithelial ovarian cancer cannot be decisively answered. Furthermore, studies applied variable timepoints during a woman's cancer journey at which they assessed her sexual function, with some studies assessing at multiple consecutive time-points which complicated result synthesis.…”

Section: Resultsmentioning

confidence: 99%

“…Age was heterogeneously recorded: some studies cited age at diagnosis (ranging from 48.3 to 63 years), 16 24 28 while others cited age at interview or survey, 16 24 mean age, 6 18–20 29–31 median age, 12 17 25 32 or modal age. 33 Age thresholds for categorizing younger versus older patients varied above or below 48 years, 34 53 years, 16 62 years, 20 or 65 years.…”

Section: Resultsmentioning

confidence: 99%

“…Vaginal dryness and dyspareunia were often reported together and discussed by 13 of the 29 (45%) studies. 12–14 16–21 23–25 36 When prevalence was documented, vaginal dryness affected 81–87% of sexually active women with epithelial ovarian cancer, 19 20 with significant intensity in up to a quarter. 20 Dyspareunia affected up to 77% of women with ovarian cancer, 19 worsening from diagnosis 24 25 and with longer survival.…”

Section: Resultsmentioning

confidence: 99%

“…Reduced sexual enjoyment and ability to orgasm were discussed by seven studies, 12 13 16 18 21 24 25 with orgasm worse in long-term survivors 12 and at 1 year post lymph node resection. 21 Up to two-thirds of women with epithelial ovarian cancer described reduced sexual satisfaction (21–66.7%) 18 19 and nearly half (29–47%) felt less satisfied since treatment.…”

Section: Resultsmentioning

confidence: 99%

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Psychosexual morbidity in women with ovarian cancer

Logue

Pugh

Jayson

2020

Int J Gynecol Cancer

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Increasing numbers of women are surviving for longer with epithelial ovarian cancer. Consequently, there is increased focus on long-term quality of life in national guidance. Psychosexual morbidity including vaginal dryness, pain during intercourse (dyspareunia), reduced libido, and negative perceived body image exacerbate stress and anxiety and impact intimate relationships. Although a priority for women with epithelial ovarian cancer, clinicians seldom discuss sexual problems. Therefore, psychosexual morbidity and the associated distress remain unaddressed. We synthesize evidence from primary qualitative and quantitative research studies exploring psychosexual morbidity in women with epithelial ovarian cancer to identify potential risk factors and common symptoms, to facilitate the identification and management of sexual problems in clinic. Literature (2008–19) from 10 databases identified 29 suitable publications (4116 patients). The papers were assessed to answer the question: “What are the key potential risk factors and presentations of psychosexual morbidity in women with epithelial ovarian cancer?” Current literature lacks consensus in defining clinically significant psychosexual morbidity in women with epithelial ovarian cancer. Discrepancies in measurement tools, questionnaires, and primary outcome measures confound result interpretation, limiting wider application. Key potential risk factors identified included: younger age (<53 years); pre-menopausal status at diagnosis; aim of treatment; extent of surgery; more courses of chemotherapy; cardiovascular co-morbidities; and anxiety and depression. Up to 75% of women with epithelial ovarian cancer reported adverse changes in their sex lives following diagnosis and, of the sexually active, vaginal dryness affected 81–87% and pain 77%. Other prevalent symptoms included: reduced sexual desire and activity, impaired orgasm, diminished perceived body image, and reduced partner intimacy. Psychosexual morbidity represents a significant unmet need for women with epithelial ovarian cancer. Effective treatment necessitates a multimodal approach encompassing medical, psychoeducational, and physiotherapy-based strategies. Future studies need agreement in their questionnaires, definitions, thresholds, and primary outcome measures for meaningful interstudy comparisons to be drawn.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Psychosexual morbidity in women with ovarian cancer

Logue

Pugh

Jayson

2020

Int J Gynecol Cancer

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The effect of fertility-sparing surgery on sexuality and global quality of life in women with malignant ovarian germ cell and sex cord stromal tumors: an analysis of the CORSETT database of the AGO study group

Hasenburg

Plett

Krämer³

et al. 2021

Arch Gynecol Obstet

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Purpose Malignant ovarian germ cell (MOGCT) and sex cord stromal tumors (SCST) are ovarian neoplasms that affect disproportionally young women. Little is known about the impact of surgical and adjuvant management of these patient’s sexual life. This study investigated the effect of fertility-sparing surgery on sexual activity and global quality of life (gQoL) in women with MOGCT and SCST. Methods CORSETT was an observational, multicenter, mixed retrospective/prospective cohort study of the AGO study group. Women of any age who had been diagnosed with MOGCTs and SCSTs between 2001 and 2011 were asked to complete the Sexual Activity Questionnaire (SAQ) and the EORTC QLQ-C30. Results In total, 355 patients were included. Of these, 152 patients with confirmed histological diagnosis had completed the questionnaires. A total of 106 patients were diagnosed with SCST and 46 with MOGCT. Totally, 83 women (55%) were sexually active. After fertility-sparing surgery, patients had a 2.6 fold higher probability for being sexually active than after non-fertility-conserving treatment (unadjusted odds ratio (OR) 2.6, p = 0.01). After adjustment for age, time since diagnosis, FIGO stage, histology and phase of disease, the OR dropped to 1.8 (p = 0.22). Of the sexually active patients, 35 (42%) reported high levels of discomfort during intercourse; 38% after fertility-sparing; and 58% after non-fertility-sparing surgery (adjusted OR 2.8, p = 0.18). Women with fertility-conserving treatment reported a significantly better global QoL (Fadj 2.1, 6.2 points difference, p = 0.03) but not more pleasure during intercourse than women without fertility-sparing surgery (Fadj 0.4, p = 0.52). Conclusion Fertility preserving approaches should be offered to every patient, when oncologically acceptable.

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