Sexual health needs and educational intervention preferences for women with cancer

Breast Cancer Res Treat. 2017 Aug;165(1):77-84. doi: 10.1007/s10549-017-4305-6. Epub 2017 May 25.

Abstract

Purpose: To assess sexual/vaginal health issues and educational intervention preferences in women with a history of breast or gynecologic cancer.

Methods: Patients/survivors completed a cross-sectional survey at their outpatient visits. Main outcome measures were sexual dysfunction prevalence, type of sexual/vaginal issues, awareness of treatments, and preferred intervention modalities. Descriptive frequencies were performed, and results were dichotomized by age, treatment status, and disease site.

Results: Of 218 eligible participants, 109 (50%) had a history of gynecologic and 109 (50%) a history of breast cancer. Median age was 49 years (range 21-75); 61% were married/cohabitating. Seventy percent (n = 153) were somewhat-to-very concerned about sexual function/vaginal health, 55% (n = 120) reported vaginal dryness, 39% (n = 84) vaginal pain, and 51% (n = 112) libido loss. Many had heard of vaginal lubricants, moisturizers, and pelvic floor exercises (97, 72, and 57%, respectively). Seventy-four percent (n = 161) had used lubricants, 28% moisturizers (n = 61), and 28% pelvic floor exercises (n = 60). Seventy percent (n = 152) preferred the topic to be raised by the medical team; 48% (n = 105) raised the topic themselves. Most preferred written educational material followed by expert discussion (66%, n = 144/218). Compared to women ≥50 years old (41%, n = 43/105), younger women (54%, n = 61/113) preferred to discuss their concerns face-to-face (p = 0.054). Older women were less interested in online interventions (52%, p < 0.001), despite 94% having computer access.

Conclusion: Female cancer patients/survivors have unmet sexual/vaginal health needs. Preferences for receiving sexual health information vary by age. Improved physician-patient communication, awareness, and educational resources using proven sexual health promotion strategies can help women cope with treatment side effects.

Keywords: Breast cancer; Gynecologic cancer; Intervention; Patient preference; Sexual health; Vaginal health.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Genital Neoplasms, Female / diagnosis
  • Genital Neoplasms, Female / epidemiology
  • Genital Neoplasms, Female / psychology
  • Genital Neoplasms, Female / therapy*
  • Health Care Surveys
  • Health Knowledge, Attitudes, Practice*
  • Health Services Needs and Demand
  • Humans
  • Middle Aged
  • Needs Assessment
  • Patient Education as Topic / methods*
  • Patient Preference*
  • Prevalence
  • Sexual Behavior
  • Sexual Dysfunction, Physiological / diagnosis
  • Sexual Dysfunction, Physiological / epidemiology
  • Sexual Dysfunction, Physiological / psychology
  • Sexual Dysfunction, Physiological / therapy*
  • Sexual Dysfunctions, Psychological / diagnosis
  • Sexual Dysfunctions, Psychological / epidemiology
  • Sexual Dysfunctions, Psychological / psychology
  • Sexual Dysfunctions, Psychological / therapy*
  • Sexual Health*
  • Treatment Outcome
  • Vagina / physiopathology
  • Young Adult