Clinical practice guidelines: sexual dysfunction in gynecological cancer patients
Sharon Peleg Nesher, Mijal Luria, Gideon Sartorius, Francesca Tripodi, Michał Lew‐Starowicz, Stephanie Both, Elisa Maseroli, Yacov Reisman, Giovanni Corona
Abstract
Background: Sexual dysfunctions (SDs) due to gynecological cancer (GC) are common. Healthcare providers (HCPs) are often not prepared to address sexual health issues, missing the opportunity to provide comprehensive post-cancer survivorship care. Aim: To review the available evidence about diagnosing and managing SD after GC and providing practical clinical suggestions on behalf of the European Society of Sexual Medicine. Methods: A systematic literature search was performed on Pubmed and Medline for the relevant literature from January 1980 until June 2024. Outcomes: Recommendations were provided according to the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence criteria, focusing on clinical practice. Results: The main areas covered include the impact of diagnosis and treatment of GC (surgery, chemotherapy, immunotherapy, and radiotherapy) on sexual health; the process of screening, counseling, and referral; medical and psychological management of SD; issues related to special populations, ie, sexual minorities and previvors. Clinical Implications: Addressing aspects of sexual health is important in patients with GC during diagnosis, treatment, and post-cancer care. Diagnosis and treatment of SDs should follow the recommendations in non-cancer patients, but specific aspects linked to cancer and its treatment should be kept in mind. Strengths and Limitations: All studies have been evaluated by a panel of experts who provide comprehensive, evidence-based recommendations for clinical practice. Conclusion: HCPs should feel comfortable addressing sexual health topics in patients with GCs due to the abundance of available data. Appropriate sexological interventions can improve the quality of life for patients and their partners.