Patients With Gynecologic Cancers Want to Discuss Sexual Health

Radiation therapy to the pelvis is commonly used to treat women with gynecologic cancer, but it comes with side effects that can affect quality of life, especially disruptions to sexual health.

Vaginal dryness, vaginal irritation, vaginal scar tissue, yeast infections and infertility are a few effects that patients can experience, all of which can affect intimate relations. However, these concerns are not always addressed by health care providers.

To better understand communication and sexual dysfunction in women after radiation therapy, researchers surveyed 75 patients from the Department of Radiation Oncology at Michigan Medicine who had received a diagnosis of endometrial, cervical, uterine, vulvar or vaginal cancer. Most of the women were white, married, heterosexual and Christian. They were asked about their attitudes/beliefs surrounding sexual health, quality of life and sexual function.

“The perception is that for patients (gynecologic cancer), sexual health is not as important because they are just happy that their cancer has been dealt with,” Shruti Jolly, M.D., associate professor, associate chair of community practices and chief of brachytherapy services at Michigan Medicine, said in an interview with CURE. “I think more and more (people), especially women, are focused on long-term quality of life, and sexual health is a major part of that because it not only affects them but also affects their partner. They want to have these discussions and if the provider isn’t open then they don’t happen.”

Researchers found that most women (89.8 percent) experienced sexual dysfunction. In addition, a majority (78.7 percent) felt that sexual function is an important part of overall health.

However, the survey results also showed a lack of communication between providers and patients. Of women who saw a primary care physician, 58.7 percent reported never or almost never being asked about their sexual health. Only 4 percent reported always or almost always being asked. Compared with women who saw an OBGYN, 22.7 percent said they never or almost never were asked about their sexual health and 17.3 percent reported being asked always or almost always.

However, 62.8 percent of patients felt providers should inquire about sexual health regularly. And surprisingly, most women surveyed did not feel embarrassed to talk about sexual health — 12 percent reported embarrassment around provider discussions.

“Sexual health cannot be ignored, and it is quite complex. It’s not just about intercourse,” Jolly said. “Increasingly cancer centers are providing sexual health services like we do at the University of Michigan. We routinely refer patients — sometimes before treatment — to talk about what to anticipate.”

Women should make it known that sexual health is a major concern and try their best to have open communication with their health care team, Jolly explained. “This is a very common concern,” she said. “Providers aren’t routinely educated on how to talk about these issues and that puts more pressure on the patient to bring up these discussions.”

Researchers concluded that educating patients and providers is a necessity. “Patients need to feel empowered to push these discussions forward,” Jolly said.