Cancer therapy takes a toll on women’s sexual health

In women being treated for cervical cancer, chemotherapy and radiotherapy appear to have a substantial and lasting negative effect on sexual health, including satisfaction and desire, as shown in a descriptive cross-sectional study conducted in Brazil.

In a cohort of 61 patients (average age 44 years), the EORTC Sexual Health Questionnaire scores for the functional domains examined (0–100, with higher scores indicating better functional level) declined over time, said first study author Dr Adriana Castelo de Moura from the Hospital Sírio-Libanês in São Paulo, Brazil.

At 6 months following treatment, the average sexual satisfaction score was 71.13, which then decreased to 64.4 in the 7–12-month period and further to 62.80 in the 13–60-month period. Similarly, libido was consistently reduced during the post-treatment follow-up period, with an average score of 52.38 at 6 months, 42.22 at 7–12 months, and 57.82 beyond 12 months. [SGO 2025, abstract 115]

“One key finding of our study is the persistent gap in communication among healthcare providers and patients regarding sexual health,” according to De Moura.

The average scores for communication about sexuality with professionals declined over time, being 85.71 at 6 months, 62.22 at 7–12 months, and 58.24 at 13–60 months. Yet, the importance attributed to sexual activity appeared to increase slightly from an average score of 45.20 at 6 months to 55.56 at 7–12 months and 52.55 at 13–60 months. The score for the impact of treatment on sexual life averaged 38.10 at 6 months then increased to 66.67 at 7–12 months and 60.42 beyond 12 months.

Scores for feeling of security with the partner were less altered (54.76 at 6 months, 73.33 at 7–12 months, and 66.81 at 13–60 months), while those for femininity were quite low (14.29 at 6 months, 2.22 at 7–12 months, and 25.05 at 13–60 months).

“Cervical cancer and its treatments, particularly chemotherapy and radiotherapy, can significantly impact a woman’s life, including sexual health, which is often overlooked in survivorship care,” De Moura said.

“Women frequently report urinary and bowel dysfunction, lymphedema, and significant sexual health challenges, including low sexual desire, decreased arousal, and pain during intercourse, all of which profoundly affect their overall wellbeing,” she continued.

The findings of this descriptive cross-sectional study highlight the need to implement early interventions to mitigate treatment-related side effects, as well as to foster a more proactive and open communication between patients and their healthcare providers, according to De Moura.

She emphasized that the dialogue about sexual health should be continuous, occurring throughout the course of the treatment and during follow-up to enhance sexual health outcomes and improve the survivors’ quality of life.

Of the 61 patients included in the study, 80.3 percent had squamous cell carcinoma, and 42.6 percent had stage IIIC1 (pelvic lymph node involvement). Most patients were never smokers (68.85 percent) and abstained from alcohol (59.02 percent).

Data were collected through medical records and the EORTC SHQ-22 sexual health questionnaire, administered in an assisted manner. The patients were grouped based on the time elapsed since their treatment: within 6 months, from 7 to 12 months, and from 13 to 60 months.