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Textbook of Oncofertility Research and Practice pp 177–190Cite as

Female Sexual Function in Childhood, Adolescent, and Young Adult Cancer Survivors

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Abstract

Female survivors of childhood, adolescent, and young adult cancers are at risk of impaired sexual functioning. Cancer and cancer treatment may alter normal sexual development and predispose women to sexual problems through both physiologic and psychosocial mechanisms. Sexual problems are classified as sexual dysfunctions when they meet the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), and cause significant distress. There are a number of effective treatments for female sexual dysfunction, though few have been rigorously evaluated in women with a history of cancer. By recognizing sexual health as a pertinent survivorship issue and through regular screening, healthcare providers can play an important role in optimizing sexual well-being in this patient population.

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References

  1. Davison SL, Bell RJ, La China M, Holden SL, Davis SR. The relationship between self-reported sexual satisfaction and general well-being in women. J Sex Med. 2009;6(10):2690–7.

    Article  Google Scholar 

  2. Field N, Mercer CH, Sonnenberg P, Tanton C, Clifton S, Mitchell KR, et al. Associations between health and sexual lifestyles in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet (London, England). 2013;382(9907):1830–44.

    Article  Google Scholar 

  3. Kornblith AB, Ligibel J. Psychosocial and sexual functioning of survivors of breast cancer. Semin Oncol. 2003;30(6):799–813.

    Article  Google Scholar 

  4. Robison LL, Hudson MM. Survivors of childhood and adolescent cancer: life-long risks and responsibilities. Nat Rev Cancer. 2014;14(1):61–70.

    Article  CAS  Google Scholar 

  5. DeSimone M, Spriggs E, Gass JS, Carson SA, Krychman ML, Dizon DS. Sexual dysfunction in female cancer survivors. Am J Clin Oncol. 2014;37(1):101–6.

    Article  Google Scholar 

  6. Cantrell MA, Conte T, Hudson M, Shad A, Ruble K, Herth K, et al. Recruitment and retention of older adolescent and young adult female survivors of childhood cancer in longitudinal research. Oncol Nurs Forum. 2012;39(5):483–90.

    Article  Google Scholar 

  7. Rechis R, Boerner L, Nutt S, Shaw K, Berno D, Duchover Y. How cancer has affected post-treatment survivors: a LIVESTRONG report. 2010. https://www.livestrong.org/sites/default/files/what-we-do/reports/LSSurvivorSurveyReport.pdf.

  8. Zebrack BJ, Foley S, Wittmann D, Leonard M. Sexual functioning in young adult survivors of childhood cancer. Psychooncology. 2010;19(8):814–22.

    Article  Google Scholar 

  9. Ford JS, Kawashima T, Whitton J, Leisenring W, Laverdiere C, Stovall M, et al. Psychosexual functioning among adult female survivors of childhood cancer: a report from the childhood cancer survivor study. J Clin Oncol Off J Am Soc Clin Oncol. 2014;32(28):3126–36.

    Article  Google Scholar 

  10. Acquati C, et al. Sexual functioning among young adult cancer patients: a 2 year longitudinal study. Cancer. 2018;124(2):398–405.

    Article  Google Scholar 

  11. Stabile C, et al. Sexual health needs and educational intervention preferences for women with cancer. Breast Cancer Res Treat. 2017;165(1):77–84.

    Article  Google Scholar 

  12. D’Agostino NM, Penney A, Zebrack B. Providing developmentally appropriate psychosocial care to adolescent and young adult cancer survivors. Cancer. 2011;177(S10):2329–34.

    Article  Google Scholar 

  13. Bober SL, Zhou ES, Chen B, Manley PE, Kenney LB, Recklitis CJ. Sexual function in childhood cancer survivors: a report from Project REACH. J Sex Med. 2013;10(8):2084–93.

    Article  Google Scholar 

  14. Murphy D, Klosky JL, Termuhlen A, Sawczyn KK, Quinn GP. The need for reproductive and sexual health discussions with adolescent and young adult cancer patients. Contraception. 2013;88(2):215–20.

    Article  Google Scholar 

  15. Wiggins DL, Wood R, Granai CO, Dizon DS. Sex, intimacy, and the gynecologic oncologists: survey results of the New England Association of Gynecologic Oncologists (NEAGO). J Psychosoc Oncol. 2007;25(4):61–70.

    Article  Google Scholar 

  16. D’Agostino NM, Penney A, Zebrack B. Providing developmentally appropriate psychosocial care to adolescent and young adult cancer survivors. Cancer. 2011;117(10 Suppl):2329–34.

    Article  Google Scholar 

  17. van Dijk EM, van Dulmen-den Broeder E, Kaspers GJ, van Dam EW, Braam KI, Huisman J. Psychosexual functioning of childhood cancer survivors. Psychooncology. 2008;17(5):506–11.

    Google Scholar 

  18. Langeveld NE, Stam H, Grootenhuis MA, Last BF. Quality of life in young adult survivors of childhood cancer. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 2002;10(8):579–600.

    CAS  Google Scholar 

  19. Pui CH, Cheng C, Leung W, Rai SN, Rivera GK, Sandlund JT, et al. Extended follow-up of long-term survivors of childhood acute lymphoblastic leukemia. N Engl J Med. 2003;349(7):640–9.

    Article  Google Scholar 

  20. Rauck AM, Green DM, Yasui Y, Mertens A, Robison LL. Marriage in the survivors of childhood cancer: a preliminary description from the Childhood Cancer Survivor Study. Med Pediatr Oncol. 1999;33(1):60–3.

    Article  CAS  Google Scholar 

  21. Kokkonen J, Vainionpaa L, Winqvist S, Lanning M. Physical and psychosocial outcome for young adults with treated malignancy. Pediatr Hematol Oncol. 1997;14(3):223–32.

    Article  CAS  Google Scholar 

  22. Puukko LR, Hirvonen E, Aalberg V, Hovi L, Rautonen J, Siimes MA. Sexuality of young women surviving leukaemia. Arch Dis Child. 1997;76(3):197–202.

    Article  CAS  Google Scholar 

  23. Fobair P, Stewart SL, Chang S, D'Onofrio C, Banks PJ, Bloom JR. Body image and sexual problems in young women with breast cancer. Psycho-Oncology. 2006;15:579–94.

    Article  Google Scholar 

  24. Rosenberg SM, Tamimi RM, Gelber S, Ruddy KJ, Bober SL, Kereakoglow S, Borges VF, Come SE, Schapira L, Partridge AH. Treatment-related amenorrhea and sexual functioning in young breast cancer survivors. Cancer. 2014;120:2264–71.

    Article  Google Scholar 

  25. Schover LR, van der Kaaij M, van Dorst E, Creutzberg C, Huyghe E, Kiserud CE. Sexual dysfunction and infertility as late effects of cancer treatment. EJC Suppl EJC Off J EORTC Eur Org Res Treat Cancer. 2014;12(1):41–53.

    Google Scholar 

  26. Spunt SL, Sweeney TA, Hudson MM, Billups CA, Krasin MJ, Hester AL. Late effects of pelvic rhabdomyosarcoma and its treatment in female survivors. J Clin Oncol Off J Am Soc Clin Oncol. 2005;23(28):7143–51.

    Article  Google Scholar 

  27. Zantomio D, Grigg AP, MacGregor L, Panek-Hudson Y, Szer J, Ayton R. Female genital tract graft-versus-host disease: incidence, risk factors and recommendations for management. Bone Marrow Transplant. 2006;38(8):567–72.

    Article  CAS  Google Scholar 

  28. Fleming ND, et al. Quality of life after radical trachelectomy for early stage cervical cancer: a 5 year prospective evaluation. Gynecol Oncol. 2016;143(3):596–603.

    Article  CAS  Google Scholar 

  29. Peri G, et al. Young patients and gastrointestinal (GI) tract malignancies – are we addressing the unmet needs? BMC Cancer. 2016;16:630.

    Article  Google Scholar 

  30. Aerts L, Christiaens MR, Enzlin P, Neven P, Amant F. Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: a prospective controlled study. Breast (Edinburgh, Scotland). 2014;23(5):629–36.

    Article  CAS  Google Scholar 

  31. Sprangers MA, Taal BG, Aaronson NK, te Velde A. Quality of life in colorectal cancer. Stoma vs. nonstoma patients. Dis Colon Rectum. 1995;38(4):361–9.

    Article  CAS  Google Scholar 

  32. Choi EK, Kim IR, Chang O, Kang D, Nam SJ, Lee JE, et al. Impact of chemotherapy-induced alopecia distress on body image, psychosocial well-being, and depression in breast cancer patients. Psychooncology. 2014;23(10):1103–10.

    Article  Google Scholar 

  33. Lehmann V, Hagedoorn M, Gerhardt CA, Fults M, Olshefski RS, Sanderman R, et al. Body issues, sexual satisfaction, and relationship status satisfaction in long-term childhood cancer survivors and healthy controls. Psychooncology. 2015;25(2):210–6.

    Article  Google Scholar 

  34. Taberna M, Inglehart RC, Pickard RK, Fakhry C, Agrawal A, Katz ML, Gillison ML. Significant changes in sexual behavior after a diagnosis of human papillomavirus-positive and human papillomavirus-negative oral cancer. Cancer. 2017;123:1156–65.

    Article  Google Scholar 

  35. Warner EL, Kent EE, Trevino KM, Parsons HM, Zebrack BJ, Kirchhoff AC. Social well-being among adolescents and young adults with cancer: a systematic review. Cancer. 2016;122:1029–37.

    Article  Google Scholar 

  36. Lauman EO, Paik A, Glasser DB, Kang J-H, Levinson B, Moreira ED Jr, Nicolosi A, Gingell C. A cross national study of subjective sexual well being among older women and men: findings from the Global Study of Sexual Attitudes and Behaviors. Arch Sex Behav. 2006;35(2):143–59.

    Article  Google Scholar 

  37. Hungr C, et al. Self-image and sexuality issues among young women with breast cancer: practical recommendations. Rev Investig Clin. 2017;69(2):114–22.

    Google Scholar 

  38. Ashing T, Padilla F, Tejero J, Kagawa-Singer M. Understanding the breast cance experience of Asian American women. Psycho-Oncology. 2003;12:38–58.

    Article  Google Scholar 

  39. Barsevick AM, Leader A, Bradley PK, Avery T, Dean LT, DiCarlo M, Hegarty SE. Post-treatment problems of African American breast cancer survivors. Support Care Cancer. 2016;24(120):4979–86.

    Article  Google Scholar 

  40. JohnsonTurbes A, Schlueter D, Moore AR, Buchanan ND, Fairley TL. Evaluation of a web-based program for African American young breast cancer survivors. Am J Prev Med. 2015;49(6):S543–9.

    Article  Google Scholar 

  41. Schover LR, Rhodes MM, Baum G, Adams JH, Jenkins R, Lewis P, Jackson KE. Sisters peer counseling in reproductive issues after treatment (SPIRIT): a peer counseling program to improve reproductive health among African American breast cancer survivors. Cancer. 2011;117(21):4983–92.

    Article  Google Scholar 

  42. American Psychiatric Association, American Psychiatric Association DSM-5 Task Force. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington, DC: American Psychiatric Association; 2013. p. xliv, 947.

    Book  Google Scholar 

  43. Children’s Oncology Group. Long-term follow-up guidelines for survivors of childhood, adolescent and young adult cancer 2013 [9/26/2015]. Version 4.0.

    Google Scholar 

  44. Metzger ML, Meacham LR, Patterson B, Casillas JS, Constine LS, Hijiya N, et al. Female reproductive health after childhood, adolescent, and young adult cancers: guidelines for the assessment and management of female reproductive complications. J Clin Oncol Off J Am Soc Clin Oncol. 2013;31(9):1239–47.

    Article  Google Scholar 

  45. Network NCC. NCCN guidelines: survivorship 2015 [cited 2015 9/01/2015]. Version 2.2015.

    Google Scholar 

  46. Baser RE, Li Y, Carter J. Psychometric validation of the Female Sexual Function Index (FSFI) in cancer survivors. Cancer. 2012;118(18):4606–18.. Epub 2012/02/24

    Article  Google Scholar 

  47. Flynn KE, Lin L, Cyranowski JM, Reeve BB, Reese JB, Jeffery DD, et al. Development of the NIH PROMIS (R) sexual function and satisfaction measures in patients with cancer. J Sex Med. 2013;10(Suppl 1):43–52. Pubmed Central PMCID: PMC3729213, Epub 2013/03/21.

    Article  Google Scholar 

  48. Althof SE, Parish SJ. Clinical interviewing techniques and sexuality questionnaires for male and female cancer patients. J Sex Med. 2013;10(Suppl 1):35–42. Epub 2013/02/15.

    Article  Google Scholar 

  49. Bradford A, Fellman B, Urbauer D, Bevers T. Effect of routine screening for sexual problems in a breast cancer survivorship clinic. Psycho-Oncology. 2016;25(11):1375.

    Article  Google Scholar 

  50. Clayton A, Ramamurthy S. The impact of physical illness on sexual dysfunction. Adv Psychosom Med. 2008;29:70–88.

    Article  Google Scholar 

  51. Dizon DS, Suzin D, McIlvenna S. Sexual health as a survivorship issue for female cancer survivors. Oncologist. 2014;19(2):202–10.

    Article  Google Scholar 

  52. Gunzler C, Berner MM. Efficacy of psychosocial interventions in men and women with sexual dysfunctions – a systematic review of controlled clinical trials: part 2 – the efficacy of psychosocial interventions for female sexual dysfunction. J Sex Med. 2012;9(12):3108–25.

    Article  Google Scholar 

  53. Kingsberg SA, Woodard T. Female sexual dysfunction: focus on low desire. Obstet Gynecol. 2015;125(2):477–86.

    Article  Google Scholar 

  54. Riley AJ, Riley EJ. A controlled study to evaluate directed masturbation in the management of primary orgasmic failure in women. Br J Psychiatry J Ment Sci. 1978;133:404–9.

    Article  CAS  Google Scholar 

  55. Reisinger JJ. Effects of erotic stimulation and masturbatory training upon situational orgasmic dysfunction. J Sex Marital Ther. 1978;4(3):177–85.

    Article  CAS  Google Scholar 

  56. Andersen BL. A comparison of systematic desensitization and directed masturbation in the treatment of primary orgasmic dysfunction in females. J Consult Clin Psychol. 1981;49(4):568–70.

    Article  CAS  Google Scholar 

  57. Brotto LA, Basson R, Luria M. A mindfulness-based group psychoeducational intervention targeting sexual arousal disorder in women. J Sex Med. 2008;5(7):1646–59.

    Article  Google Scholar 

  58. Canada AL, Schover LR, Li Y. A pilot intervention to enhance psychosexual development in adolescents and young adults with cancer. Pediatr Blood Cancer. 2007;49(6):824–8.

    Article  Google Scholar 

  59. Bober SL, et al. Improvement in sexual function after ovarian cancer: effects of sexual therapy and rehabilitation after treatment for ovarian cancer. Cancer. 2018;124(1):176–82.

    Article  Google Scholar 

  60. Yang EJ, Lim JY, Rah UW, Kim YB. Effect of a pelvic floor muscle training program on gynecologic cancer survivors with pelvic floor dysfunction: a randomized controlled trial. Gynecol Oncol. 2012;125(3):705–11.

    Article  Google Scholar 

  61. Bakker RM, ter Kuile MM, Vermeer WM, Nout RA, Mens JW, van Doorn LC, et al. Sexual rehabilitation after pelvic radiotherapy and vaginal dilator use: consensus using the Delphi method. Int J Fynecolog Cancer Off J Int Gynecol Cancer Soc. 2014;24(8):1499–506.

    Article  Google Scholar 

  62. Miles T, Johnson N. Vaginal dilator therapy for women receiving pelvic radiotherapy. Cochrane Database Syst Rev. 2014;9:CD007291.

    Google Scholar 

  63. Law E, Kelvin JF, Thom B, Riedel E, Tom A, Carter J, et al. Prospective study of vaginal dilator use adherence and efficacy following radiotherapy. Radiother Oncol J Eur Soc Ther Radiol Oncol. 2015;116(1):149–55.

    Article  Google Scholar 

  64. Portman DJ, Bachmann GA, Simon JA. Ospemifene, a novel selective estrogen receptor modulator for treating dyspareunia associated with postmenopausal vulvar and vaginal atrophy. Menopause (New York, NY). 2013;20(6):623–30.

    Article  Google Scholar 

  65. Labrie F, Martel C, Berube R, Cote I, Labrie C, Cusan L, et al. Intravaginal prasterone (DHEA) provides local action without clinically significant changes in serum concentrations of estrogens or androgens. J Steroid Biochem Mol Biol. 2013;138:359–67.

    Article  CAS  Google Scholar 

  66. Davis SR, Goldstat R, Papalia MA, Shah S, Kulkarni J, Donath S, et al. Effects of aromatase inhibition on sexual function and well-being in postmenopausal women treated with testosterone: a randomized, placebo-controlled trial. Menopause (New York, NY). 2006;13(1):37–45.

    Article  Google Scholar 

  67. Segraves RT, Clayton A, Croft H, Wolf A, Warnock J. Bupropion sustained release for the treatment of hypoactive sexual desire disorder in premenopausal women. J Clin Psychopharmacol. 2004;24(3):339–42.

    Article  CAS  Google Scholar 

  68. Safarinejad MR. Reversal of SSRI-induced female sexual dysfunction by adjunctive bupropion in menstruating women: a double-blind, placebo-controlled and randomized study. J Psychopharmacol (Oxford, England). 2011;25(3):370–8.

    Article  CAS  Google Scholar 

  69. Pereira VM, Arias-Carrion O, Machado S, Nardi AE, Silva AC. Bupropion in the depression-related sexual dysfunction: a systematic review. CNS Neurol Disord Drug Targets. 2014;13(6):1079–88.

    Article  CAS  Google Scholar 

  70. Mathias C, Cardeal Mendes CM, Ponde de Sena E, Dias de Moraes E, Bastos C, Braghiroli MI, et al. An open-label, fixed-dose study of bupropion effect on sexual function scores in women treated for breast cancer. Ann Oncol Off J Eur Soc Med Oncol/ESMO. 2006;17(12):1792–6.

    Article  CAS  Google Scholar 

  71. Katz M, DeRogatis LR, Ackerman R, Hedges P, Lesko L, Garcia M Jr, et al. Efficacy of flibanserin in women with hypoactive sexual desire disorder: results from the BEGONIA trial. J Sex Med. 2013;10(7):1807–15.

    Article  CAS  Google Scholar 

  72. Dhanuka I, Simon JA. Flibanserin for the treatment of hypoactive sexual desire disorder in premenopausal women. Expert Opin Pharmacother. 2015;22:1–7.

    Google Scholar 

  73. Herbenick D, Reece M, Hollub A, Satinsky S, Dodge B. Young female breast cancer survivors: their sexual function and interest in sexual enhancement products and services. Cancer Nurs. 2008;31(6):417–25.

    Article  Google Scholar 

  74. Lindau ST, Abramsohn EM, Matthews AC. A manifesto on the preservation of sexual function in women and girls with cancer. Am J Obstet Gynecol. 2015;213(2):166–74. Epub 2015/03/31. eng.

    Article  Google Scholar 

  75. De Rosa N, Lavitola G, Giampaolino P, Morra I, Nappi C, Bifulco G. Impact of ospemifene on quality of life and sexual function in young survivors of cervical cancer: a prospective study. Biomed Res Int. 2017;2017:7513610.

    PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Terri L. Woodard

  2. Division of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, TX, USA

    Terri L. Woodard

  3. Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Andrea Bradford

  4. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, TX, USA

    Sukhkamal Campbell

Authors
  1. Terri L. Woodard
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  2. Andrea Bradford
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  3. Sukhkamal Campbell
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Corresponding author

Correspondence to Terri L. Woodard .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Northwestern University , Chicago, IL, USA

    Teresa K. Woodruff

  2. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA

    Divya K. Shah

  3. Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA

    Wendy S. Vitek

Review Questions and Answers

Review Questions and Answers

  1. Q1.

    What percentage of survivors of childhood cancer experience sexual problems?

  2. A1.

    42.7%

  3. Q2.

    What are the three categories of female sexual dysfunction defined in the DSM-5?

  4. A2.

    Female orgasmic disorder, female sexual interest/arousal disorder, and genito-pelvic pain/penetration disorder.

  5. Q3.

    Name several non-pharmacologic therapies for the treatment of female sexual dysfunction.

  6. A3.

    Sex therapy, cognitive-behavioral therapy, and pelvic floor physical therapy.

  7. Q4.

    Name several risk factors for sexual dysfunction in female survivors of childhood cancer.

  8. A4.

    Older age at cancer diagnosis, having other health problems, ovarian failure, and a history of cranial radiation.

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Woodard, T.L., Bradford, A., Campbell, S. (2019). Female Sexual Function in Childhood, Adolescent, and Young Adult Cancer Survivors. In: Woodruff, T., Shah, D., Vitek, W. (eds) Textbook of Oncofertility Research and Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-02868-8_14

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  • DOI: https://doi.org/10.1007/978-3-030-02868-8_14

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