Psychosexual function and impact of gynaecological cancer.

A diagnosis of gynaecological cancer and its treatment are usually associated with many physical and psychological changes, both as a result of the diagnosis itself and of the usual treatments of surgery, radiotherapy and/or several months of chemotherapy. Patients often experience symptoms such as fatigue, abdominal swelling and pain, and suffer from emotional distress and disturbances of their life style. Sexual functioning can also be affected. Often there are physiological difficulties, such as vaginal dryness, together with psychological distress and relationship problems. This chapter discusses the ways in which gynaecological cancer can impact sexual functioning, and presents findings from a research project that was undertaken to begin to understand how sexual functioning can be affected by ovarian cancer. The article also makes recommendations for how health-care professionals can help women to cope better with psychosexual dysfunction following a diagnosis of a gynaecological cancer.

Sexual function after treatment for gynecological malignancy.

PURPOSE OF REVIEW: This review summarizes current knowledge about the nature of sexual dysfunction in gynecological cancers, highlighting recent publications on disease effects, treatment effects, and communication issues. RECENT FINDINGS: Recent studies have shown the impact of radiotherapy on sexual function in cervical cancer and have highlighted differences in the levels and duration of sexual problems in women with early stage compared with advanced, recurrent, or persistent disease. Qualitative studies in cervical and endometrial cancer have highlighted women's concerns in relation to femininity, fears of sexual relations, and the importance of communication with the woman's partner. Similar findings have been obtained in studies of ovarian cancer. Predictors of sexual function in ovarian cancer have been suggested by a recent study, with risk factors for poorer sexual functioning being age, treatment, time since treatment, poor self esteem/body image, physical symptoms, poor performance status, depression, and anxiety. Similar risk factors have been highlighted in vulval cancer. Communication issues have been discussed, with some preliminary exploration of the benefits of group therapy and psychosexual counseling. SUMMARY: Recent research is helping us to understand more about the impact of the different types of gynecological cancer and its treatment on sexual functioning, with information being provided about key risk factors and predictors of sexual dysfunction that can be used to guide appropriate advice and support. The assessment and treatment of sexual functioning must become part of the standard care of women diagnosed with gynecological cancer.

Psychometric properties of the Body Image Scale in women with benign gynaecological conditions.

OBJECTIVES: To evaluate the psychometric properties of the Body Image Scale (originally designed for use in cancer) in women with benign gynaecological conditions. STUDY DESIGN: Prospective completion of the Body Image Scale by women participating in the EVALUATE Hysterectomy Trial. The scale was completed pre-operatively, then 6 weeks, 4 and 12 months post-operatively. The psychometric properties were evaluated by assessing the reliability, response prevalence, discriminant validity and sensitivity to change. Factor analysis was also conducted to determine the scale structure. RESULTS: The Body Image Scale showed good reliability and clinical validity. Differences between sub-groups of women were detected, demonstrating good discriminant validity. The Body Image Scale was shown to be responsive to changes in body image. CONCLUSIONS: The Body Image Scale was shown to be a reliable and valid tool for assessing body image in women with benign gynaecological conditions and for use in clinical trials involving such women.

Sexual dysfunction after treatment for gynaecologic and breast malignancies.

PURPOSE OF REVIEW: This review summarizes current knowledge about the nature of sexual dysfunction in gynaecologic and breast cancers, highlighting recent publications on treatment effects and communication issues. RECENT FINDINGS: In both gynaecologic and breast cancer, sexual dysfunction causes much distress to patients, from the time of diagnosis through to long-term follow-up. It appears that younger women in particular experience difficulties related to loss of reproductive function and relationship problems, plus more abrupt vaginal changes, than older women. Chemotherapy has been shown to be associated with short and long-term effects on sexual functioning and quality of life in breast cancer, and it is anticipated that this would extend to gynaecologic cancers also. The addition of endocrine treatments to chemotherapy in breast cancer appears not to affect levels of sexual functioning, although this may depend on the age of the woman. Sexual self-schema appears to be an important concept in predicting sexual dysfunction. Communication with women about sexual issues is vital, but evidence suggests this is lacking. SUMMARY: We are beginning to understand more about the sexual implications of different treatments and to identify factors which predict sexual dysfunction. More research is still required to identify how sexual dysfunction is affected in different groups of women and how best to help women who experience sexual difficulties. Recent findings suggest that there is a need to increase communication and support about sexual issues.