Higher levels of distress were linked to increased vaginal sexual symptoms, worry about dyspareunia, dissatisfaction with a relationship, and concerns about body image in a study looking at sexual well-being among cervical cancer survivors published in Psycho-Oncology, Prior to this publication, biopsychosocial aspects of sexual distress among cancer survivors had rarely been studied, although it is well known that psychological factors may impact sexual function as significantly as physical factors.
The cross-sectional study used a self-administered questionnaire to gather information and enrolled 252 women in partner relationships from a pool of 764 patients who had undergone surgery between 2000 and 2011 at Leiden University Medical Center or the Center for Gynecological Oncology Amsterdam in The Netherlands. Eighteen percent of the women (n=46) had received pelvic external beam radiation therapy (EBRT) with vaginal brachytherapy (BT) as their primary therapy. The other 82% (n=206) had undergone radical hysterectomy with pelvic lymphadenectomy (RHL), and of these, 82% or 157 women received RHL alone. The rest had RHL plus EBRT or RHL plus EBRT/BT. Most of the women had cancers that were stage IIB-IA, according to the International Federation of Gynecology and Obstetrics (FIGO) staging system.
Among the 252 cancer survivors in partner relationships who were enrolled, 194 were sexually active and studied in this analysis. The women were between 25 and 69 years old, with an average age of 46.2 years. Average duration of their relationships was 17 years.
A variety of instruments to measure sexual distress, vaginal sexual symptoms, sexual pain worries, anxiety and depression, body image concerns, and relationship dissatisfaction were incorporated into the questionnaire. For instance, the 12-item Female Sexual Distress Scale (FSDS) was used to measure sexual distress. Information was also gathered about age, duration of relationships and sexual activity.