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Sexual Health in Women Affected by Cancer: Focus on Sexual Pain

Coady, Deborah, MD; Kennedy, Vanessa, MD

doi: 10.1097/AOG.0000000000001621
Contents: Oncology: Clinical Expert Series
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As cancer therapies improve, the number of women surviving or living long lives with cancer continues to increase. Treatment modalities, including surgery, chemotherapy, radiotherapy, and hormonal therapy, affect sexual function and may cause sexual pain through a variety of mechanisms, depending on treatment type. Adverse sexual effects resulting from ovarian damage, anatomic alterations, and neurologic, myofascial, or pelvic organ injury may affect more than half of women affected by cancer. Despite the fact that no specialty is better qualified to render care for this consequence of cancer treatments, many obstetrician–gynecologists (ob-gyns) feel uncomfortable or ill-equipped to address sexual pain in women affected by cancer. Asking about sexual pain and dyspareunia and performing a thorough physical examination are essential steps to guide management, which must be tailored to individual patient goals. Understanding the cancer treatment-related pathophysiology of sexual pain aids in providing this care. Effective mechanism-based treatments for sexual pain and dyspareunia are available, and by using them, knowledgeable ob-gyns can enhance the quality of life of potentially millions of women affected by cancer.

Women affected by cancer commonly experience sexual pain and dyspareunia related to cancer treatments; knowledgeable clinicians can effectively diagnose and treat this adverse effect.

New York University Langone Medical Center, New York, New York; and the University of California Davis Medical Center, Sacramento, California.

Corresponding author: Vanessa Kennedy, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California Davis Medical Center, 4860 Y Street, Suite 2500, Sacramento, CA 95817; e-mail:

Financial Disclosure The authors did not report any potential conflicts of interest.

Continuing medical education for this article is available at

The authors thank the members of the Scientific Network on Female Sexual Health and Cancer for their support and editorial input.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.