A Psychoeducational Intervention for Sexual Dysfunction in Women with Gynecologic Cancer

Abstract

Treatment of early-stage cervical and endometrial cancer has been associated with significant sexual difficulties in at least half of women following hysterectomy. Despite the fact that women report such sexual side effects to be the most distressing aspect of their cancer treatment, evidence-based treatments for Female Sexual Arousal Disorder (FSAD), the most common sexual symptom in this group, do not exist. We developed and pilot tested a brief, three session psychoeducational intervention (PED) targeting FSAD in 22 women with early-stage gynecologic cancer. The PED consisted of three, 1-h sessions that combined elements of cognitive and behavioral therapy with education and mindfulness training. Women completed questionnaires and had a physiological measurement of genital arousal at pre- and post-PED (sessions 1 and 4) and participated in a semi-structured interview (session 4) during which their feedback on the PED was elicited. There was a significant positive effect of the PED on sexual desire, arousal, orgasm, satisfaction, sexual distress, depression, and overall well-being, and a trend towards significantly improved physiological genital arousal and perceived genital arousal. Qualitative feedback indicated that the PED materials were very user-friendly, clear, and helpful. In particular, women reported the mindfulness component to be most helpful. These findings suggest that a brief 3-session PED can significantly improve aspects of sexual response, mood, and quality of life in gynecologic cancer patients, and has implications for establishing the components of a psychological treatment program for FSAD.

Sexual Self Schema as a Moderator of Sexual and Psychological Outcomes for Gynecologic Cancer Survivors

“…Regarding the psychosocial literature, the majority consists of clinical description (as this study is) and few test models or variables related to heightened risk. Few intervention studies have been conducted, and of them only five have included sexuality as a treatment targets or outcomes (Brotto et al, 2008;Caldwell et al, 2003;Capone, Good, Westie, & Jacobson, 1980;Robinson, Faris, & Scott, 1999;Scott et al, 2004).…”

Reconceptualizing Cancer Survivorship Through Veterans’ Lived Experiences

“…Health care services that address the specific needs of survivors are severely lacking, and this issue is compounded by the variability of cancer illness experiences (Institute of Medicine, 2005;Khan, Rose, & Evans, 2012). For example, patients may need mental health interventions to help them cope with fears that their cancer may someday return (Herschbach et al, 2010;Humphris & Ozakinci, 2008) or psychoeducational interventions to learn skills to manage fatigue (Stanton et al, 2005) and changes to one's sexual health (Brotto et al, 2008). Survivorship research emerged to better articulate this experience and offer appropriate care to meet patients' individual needs (Aziz & Rowland, 2003).…”

Brief psychosexual therapy: reflections on the provision of a time-limited therapy service in a sexual health clinic

“…To date, the application of mindfulness to psychosexual therapy has tended to take the form of brief interventions designed to help women with sexual function problems. Empirical studies of such interventions -delivered in both individual and group therapy formats -indicate that they are associated with a reduction in sexual distress, greater awareness of sexual arousal, and improvements in sexual function and satisfaction (Brotto, Basson & Luria 2008;Brotto, Heiman, Goff, et al, 2008;Brotto, Seal & Rellini, 2012).…”