Colorectal cancer tied to long-term sexual health risks in women
A recent study found that women with colorectal cancer face an increased long-term risk of pain during sex, early menopause, and pelvic disease.
Colorectal cancer tied to long-term sexual health risks in women | Image Credit: © SewcreamStudio - stock.adobe.com.
A population-based study led by the University of British Columbia has identified significant long-term sexual and gynecologic health complications among female colorectal cancer (CRC) survivors, shedding light on an often-overlooked aspect of cancer survivorship. The research, published in the Journal of the National Cancer Institute, examined outcomes among more than 25,000 women diagnosed with CRC in British Columbia between 1985 and 2017.1,2
The study compared CRC survivors to over 250,000 age-matched cancer-free controls, evaluating five clinically diagnosed sexual and reproductive health outcomes: dyspareunia (pain during intercourse), pelvic inflammatory disease (PID), endometriosis, abnormal uterine bleeding, and premature ovarian failure. Stratified analyses by age and treatment exposures provided insight into the unique risks facing both younger and older women.
Across the entire cohort, women with CRC had a 67% higher risk of dyspareunia (HR 1.67; 95% CI: 1.62–1.73), a 3.4-fold higher risk of PID (HR 3.42; 95% CI: 3.07–3.81), and nearly double the risk of endometriosis (HR 1.95; 95% CI: 1.69–2.25) compared to cancer-free counterparts. In women diagnosed before age 40, the risk of dyspareunia rose to 90% (HR 1.90; 95% CI: 1.58–2.28), and the likelihood of premature ovarian failure was 75% higher (HR 1.75; 95% CI: 1.40–2.19).
The authors also identified treatment-related risks. Among women with CRC, surgery, chemotherapy, and radiation were each independently associated with increased risk of dyspareunia. Chemotherapy in women under 40 was associated with a 164% higher risk of premature ovarian failure (HR 2.64; 95% CI: 1.65–4.22). Rectal cancer and radiation treatment were strongly linked to elevated rates of PID.
“Sexual health is a fundamental part of quality of life, yet it’s an area that needs much more emphasis in colorectal cancer survivorship care,” said senior author Mary De Vera, PhD, MSc, BSc, an associate professor in UBC’s faculty of pharmaceutical sciences. “What our study shows is that these issues aren’t rare—they’re common, significant, and often only diagnosed well after treatment has ended.”
De Vera, herself a CRC survivor, said, “As someone who was diagnosed with colorectal cancer, I know how difficult it can be to deal with sexual health issues afterward. In my patient communities, I’ve seen how often these challenges are experienced—but with very little support.”
While prior studies have primarily relied on self-reported data from smaller cohorts, this is one of the first to use linked administrative health records to examine clinically diagnosed sexual health outcomes in CRC survivors. The authors noted the importance of including younger women in such analyses, as rates of early-onset colorectal cancer continue to rise.
Lori Brotto, PhD, co-author and professor of medicine at UBC, emphasized the clinical implications: “Addressing sexual health in cancer care is still not standard of practice, and many healthcare providers attribute this to lack of training in the various ways that cancer can impact a patient’s sexual health. These findings highlight the importance of all healthcare providers receiving some training in identifying sexual problems, and in being aware of evidence-based supports for survivors.”
The researchers urge increased awareness among clinicians and call for better integration of sexual health assessments into CRC survivorship care. “Identifying and acknowledging these issues is the first step toward more comprehensive, compassionate care for women after cancer,” said De Vera.
The study underscores the complex interplay between cancer treatment, age, and long-term reproductive health outcomes. The authors recommend further research to develop interventions and support tools for female survivors of colorectal cancer.
References:
1. University of British Columbia. Colorectal cancer leaves lasting toll on women’s sexual health. Eurekalert. June 4, 2025. Accessed June 13, 2025. https://www.eurekalert.org/news-releases/1086167
2. Oveisi N, Sayre EC, Brotto LA, et al. Sexual health outcomes after colorectal cancer diagnosis in females: a population-based cohort study. Journal of the National Cancer Institute, 2025. djaf120, https://doi.org/10.1093/jnci/djaf120
