Association of mindfulness with female sexual dysfunction.

OBJECTIVES: Female sexual dysfunction (FSD) affects women of all ages. It is often a multifactorial problem with a strong psychosocial component. Mindfulness may help alleviate FSD with nonjudgmental, present-moment awareness and decreased emotional reactivity. The goal of this study was to assess the association between dispositional or trait mindfulness and FSD. STUDY DESIGN: In this cross-sectional study at a tertiary care women's health clinic, 1718 cisgender women (mean age, 51.9 years) completed the Mindfulness Attention Awareness Scale (MAAS), Female Sexual Function Index (FSFI), and Female Sexual Distress Scale-Revised (FSDS-R). MAIN OUTCOME MEASURES: Regression analysis was used to test the associations of mindfulness, sexual function, and sexual distress with univariate and multivariable analyses, adjusting for potential confounders. RESULTS: Within the sample, 57% of women met FSD criteria (FSFI scores ≤26.55 and FSDS-R ≥ 11). On univariate analysis, higher MAAS scores, signifying greater mindfulness, were associated with higher (better) sexual function scores, lower sexual distress scores, and lower odds of FSD. This association persisted on multivariable analysis after adjusting for potential confounders. CONCLUSIONS: Higher trait mindfulness was associated with better sexual function, lower sexual distress, and lower likelihood of FSD. Further studies are needed to assess the role of mindfulness in mitigating FSD.

Surveillance and Care of the Gynecologic Cancer Survivor.

BACKGROUND: Care of the gynecologic cancer survivor extends beyond cancer treatment to encompass promotion of sexual, cardiovascular, bone, and brain health; management of fertility, contraception, and vasomotor symptoms; and genetic counseling. METHODS: This is a narrative review of the data and guidelines regarding care and surveillance of the gynecologic cancer survivor. We searched databases including PubMed, Cochrane, and Scopus using the search terms gynecologic cancer, cancer surveillance, and cancer survivor and reached a consensus for articles chosen for inclusion in the review based on availability in the English language and publication since 2001, as well as key older articles, consensus statements, and practice guidelines from professional societies. However, we did not undertake an extensive systematic search of the literature to identify all potentially relevant studies, nor did we utilize statistical methods to summarize data. We offer clinical recommendations for the management of gynecologic cancer survivors based on review of evidence and our collective clinical experience. RESULTS: Key messages include the limitations of laboratory studies, including CA-125, and imaging in the setting of gynecologic cancer surveillance, hormonal and non-hormonal management of treatment-related vasomotor symptoms and genitourinary syndrome of menopause, as well as recommendations for general health screening, fertility preservation, and contraception. CONCLUSIONS: A holistic approach to care extending beyond cancer treatment alone benefits gynecologic cancer survivors. In addition to surveillance for cancer recurrence and late treatment side effects, survivors benefit from guidance on hormonal, contraceptive, and fertility management and promotion of cardiovascular, bone, brain, and sexual health.

Caring for the breast cancer survivor's health and well-being.

The breast cancer care continuum entails detection, diagnosis, treatment, and survivorship. During this time, focus on the whole woman and medical concerns beyond the breast cancer diagnosis itself is essential. In this comprehensive review, we critically review and evaluate recent evidence regarding several topics pertinent to and specific for the woman living with a prior history of breast cancer. More specifically, we discuss the most recent recommendations for contraceptive options including long-acting reversible contraception and emergency contraception, fertility and pregnancy considerations during and after breast cancer treatment, management of menopausal vasomotors symptoms and vulvovaginal atrophy which often occurs even in young women during treatment for breast cancer. The need to directly query the patient about these concerns is emphasized. Our focus is on non-systemic hormones and non-hormonal options. Our holistic approach to the care of the breast cancer survivor includes such preventive health issues as sexual and bone health,which are important in optimizing quality of life. We also discuss strategies for breast cancer recurrence surveillance in the setting of a prior breast cancer diagnosis. This review is intended for primary care practitioners as well as specialists caring for female breast cancer survivors and includes key points for evidence-based best practice recommendations.