To try to understand the toll of sexual dysfunc-
tion on relationships, gynecologic oncologist
Saketh Guntupalli at the University of Colorado
Cancer Center in Aurora and colleagues surveyed
more than 300 women of all ages with all stages of
gynecologic cancer. The study, published in March
2017 in the International Journal of Gynecological
Cancer, found that about 40 percent of sexually
active women experienced sexual dysfunction after
diagnosis and treatment. Women who had sexual
dysfunction were more likely to be in relationship
counseling, but their rates of separation or divorce
were no higher than those of other cancer survi-
vors in the study.
Maryann Karinch, 65, was already in counseling with her husband around the time she was
diagnosed with fast-growing stage I endometrial
cancer in 2014. Within weeks of her diagnosis,
the literary agent and author from Estes Park,
Colorado, had a complete hysterectomy, followed
by three rounds of chemotherapy and six rounds
of radiation, called brachytherapy, where the
radiation source is inserted directly into the
vagina. She and her husband had been facing
marital challenges, but the diagnosis united the
pair into a team focused on Karinch’s treatment
and recovery. “Cancer is traumatic, and it brings
out your natural predispositions about a lot of
things,” she says.
The radiation treatments that Karinch received
can lead to scarring that can prevent vaginal intercourse. For some women with extensive scarring, a
dilator, a device that opens the vaginal canal, may
be recommended, but Karinch’s physician assistant
said the couple had the option of having sex four
times a week instead of using a dilator. Karinch
recalls that she and her husband looked at each
other and said, “We’ll have sex.”
Devices and strategies like these can help both
women and men address sexual issues. For women
who are experiencing vaginal dryness as a result
of cancer treatments, lubrication can make sex
more comfortable. Pelvic floor physical therapy,
hormone therapy and other medications that
can relieve the pain of intercourse can help both
women and men. Men can use pumps and medications such as Viagra (sildenafil citrate) or Cialis
(tadalafil) to increase erectile function. Surgical
implants may also help.
Resources for Survivors
The American Cancer Society provides information for overcoming
challenges related to fertility and sexuality after a cancer diagnosis.
The National Cancer Institute recommends questions to ask health care
providers about sexual side effects of cancer treatments.
Will2Love, developed by psychologist Leslie Schover, features resources,
including self-help programs and courses, for people with chronic illnesses
who face sexual challenges.
Sex and Cancer: Intimacy, Romance and Love After Diagnosis and Treatment, by
gynecologic oncologist Saketh Guntupalli and endometrial cancer survivor
Maryann Karinch, highlights stories of gynecologic cancer survivors. It also
includes information about sexual dysfunction and how to address it.
Techniques to help connect mind and body
may also help to increase sexual satisfaction.