Sexual health in Belgian cervical cancer survivors: an exploratory qualitative study

PURPOSE

To assess experiences of sexuality and of receiving sexual healthcare in cervical cancer (CC) survivors.

METHODS

A qualitative phenomenological study using semistructured one-on-one interviews was conducted with 15 Belgian CC survivors recruited in 5 hospitals from August 2021 to February 2022. The interviews were audiotaped and transcribed verbatim. Data were analyzed using inductive thematic analysis. COREQ and SRQR reporting guidelines were applied.

RESULTS

Most participants experienced an altered sexuality after CC treatment with often long-term loss/lack of sex drive, little/no spontaneity, limitation of positions to avoid dyspareunia, less intense orgasms, or no sexual activity at all. In some cases, emotional intimacy became more prominent. Physical (vaginal bleeding, vaginal dryness, dyspareunia, menopausal symptoms) and psychological consequences (guilt, changed self-image) were at the root of the altered sexuality. Treatment-induced menopause reduced sex drive. In premenopausal patients, treatment and/or treatment-induced menopause resulted in the sudden elimination of family planning. Most participants highlighted the need to discuss their altered sexual experience with their partner to grow together toward a new interpretation of sexuality. To facilitate this discussion, most of the participants emphasized the need for greater partner involvement by healthcare providers (HPs). The oncology nurse or sexologist was the preferred HP with whom to discuss sexual health. The preferred timing for information about the sexual consequences of treatment was at treatment completion or during early follow-up.

CONCLUSION

Both treatment-induced physical and psychological experiences were prominent and altered sexuality. Overall, there was a need for HPs to adopt proactive patient-tailored approaches to discuss sexual health.

Cervical cancer survivors' and partners' experiences with sexual dysfunction and psychosexual support

PURPOSE

The purpose of the study was to assess experiences with sexual dysfunctions, psychosexual support, and psychosexual healthcare needs among cervical cancer survivors (CCSs) and their partners.

METHODS

Semi-structured interviews were conducted with CCSs (n = 30) and their partners (n = 12).

RESULTS

Many participants experienced one or more sexual dysfunctions often causing feelings of distress. Most participants reported having been asked about their sexual functioning, although attention for sexual functioning was often limited and medically oriented. Considering sexuality a taboo topic hampered some participants to seek help. Many participants desired information about treatment consequences for sexual functioning, practical advice on dealing with dysfunctions, and reassurance that it is common to experience sexual dysfunction. A website was generally considered a useful and accessible first resource for information about sexual functioning after cancer.

CONCLUSIONS

Sexual dysfunctions are often distressing. Many patients and partners experience psychosexual healthcare needs, but the provided information and care is generally limited. Psychosexual support should go beyond physical sexual functioning and should take aspects such as sexual distress, relationship satisfaction, and the partner perspective into account. Additionally, offering more practical and reassuring information about sexuality after cervical cancer would be valuable for both CCSs and their partners.