Chapter 27: Living with and beyond cancer
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Gynaecological cancers
Sexual dysfunction is common in gynaecological cancers as these cancers directly affect a woman's sexual organs. Treatment for these cancers may vary depending on the specific cancer site (i.e. endometrium, vulva and cervix, ovary).
Surgery may include vulvectomy, radical hysterectomy, bilateral salpingo‐oophorectomy and pelvic exenteration. Sexual problems such as body image changes, pain, loss of sensation, vaginal dryness and orgasm difficulties can occur in patients who have undergone vulvectomy and hysterectomy. Following salpingo‐oophorectomy the development of sexual difficulties early after treatment may be related to hot flushes, mood changes and sleep disturbance resulting from the abrupt onset of menopause with the later developing symptoms of vaginal dryness, dyspareunia and low libido further resulting in sexual function disturbance (Carter et al. [42]).
The inclusion of chemotherapy or radiotherapy or both increases the risk of severe sexual problems. Radiotherapy can cause damage to the pelvic organs including the vagina, bladder, rectum and uterus (if present), making these women vulnerable to vaginal stenosis and bowel problems (Varela et al. [279]).
