Factors of sexual quality of life in gynaecological cancers: a systematic literature review

Abstract

Background The impact of cancer diagnosis and treatment on sexual quality of life (SQoL) is a well-established survivorship issue for gynaecological cancer survivors (GCS), yet little is known on how to intervene. Purpose The aim of this systematic review was to identify the factors explaining the variability in SQoL for GCS. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and the software Covidence. Electronic databases Scopus, Web of Science, PUBMED and CINAHL were searched for original research on GCS published between 2002 and 2018. We performed a two-stage screening process against selection criteria and quality assessment of individual studies. The Salutogenic Theory and the PRECEDE–PROCEED model were used as theoretical frameworks to identify and categorise factors. Results The initial search yielded 3,505 articles resulting in a total of 46 studies used to examine the association between factors of SQoL and gynaecological cancers. Our findings suggested that SQoL varies across subgroups based on age, menopausal status, relationship status, and treatment modality. Protective factors included clinicians’ knowledge and confidence, preventive medical approach, risk and needs assessment, patient–clinician communication, relationship quality, psychosocial support, symptom management, accessibility of psychosexual care, and self-efficacy in the rediscovery of sexuality. Conclusion Despite the high incidence and long-term impact of sexual health issues on quality of life, supportive care needs are not being met. A better understanding of the evidence base around the factors of SQoL can help health professionals take steps to protect and improve SQoL in GCS.

A Pilot Study of Psychosexual Functioning and Communication in Women Treated for Advanced Stages of Cervical Cancer After the Diagnosis

“…Women with gynecological cancer may experience decreased sexual function from the moment of diagnosis (Grion et al, 2016), which could result from psychological symptoms after diagnosis or treatment-related issues. Women reported a significant impairment of sexual functioning in comparison to the control group, with results implicating no sexual dysfunctions, which is consistent with previous studies regarding sexuality in CC patients (Cleary & Hegarty, 2011;Ekwall et al, 2003;Grion et al, 2016;Roussin et al, 2021;Thapa et al, 2018). The perception of sexual activity in women is considered to be very interesting in terms of understanding the results.…”

Evaluation of the Nurse-Led Symptom Management Program for Patients With Gynecologic Cancer Undergoing Chemotherapy

“…Although help-seeking behavior seems inadequate, it is recommended that healthcare professionals initiate a discussion with patients regarding sexual functions 35 . Initiating discussion on sexual issues at an earlier stage may lead to better sexual outcomes; with this, women represent more desire for communication, information, support, and intervention relating to sexual dysfunction 32,35 . In the NL- SMP, sexual functions were addressed at the beginning of the treatment, and during the chemotherapy, patient- and symptom-specific education was provided to improve women’s sexuality.…”

Vaginal Toxicity Management in Patients with Locally Advanced Cervical Cancer following Exclusive Chemoradiation—A Nationwide Survey on Knowledge and Attitudes by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Gynecology Study Group

“…Radiation-induced vaginal stenosis and dyspareunia may have a substantial adverse impact on patient wellbeing due to the impairment of sexual quality of life, and it represents a dysfunction that is likely underreported [ 23 ]. Although sexuality, recognized as a human right and being a key component of quality of life, represents an important public-health issue in the setting of long-term-survivor LACC patients, the integration of sexuality management in routine care is frequently lacking [ 24 , 25 , 26 ].…”