Interventions for sexual dysfunction following treatments for cancer in women

Abstract

Background The proportion of people living with and surviving cancer is growing. This has led to increased awareness of the importance of quality of life, including sexual function, in those affected by cancer. Sexual dysfunction is a potential long-term complication of many cancer treatments. This includes treatments that have a direct impact on the pelvic area and genitals, and also treatments that have a more generalised (systemic) impact on sexual function. This is an update of the original Cochrane review published in Issue 4, 2007, on interventions for treating sexual dysfunction following treatments for cancer for men and women. Since publication in 2007, there has been an increase in the number of trials for both men and women and this current review critiques only those for women. A review in press will present those for men. Objectives To evaluate the effectiveness of interventions for treating sexual dysfunction in women following treatments for cancer. To assess adverse events associated with interventions. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 9), MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, Dissertation Abstracts and the NHS Research Register. The searches were originally run in January 2007 and we updated these to September 2015. Selection criteria We included randomised controlled trials (RCTs) that assessed the effectiveness of a treatment for sexual dysfunction. The trial participants were women who had developed sexual dysfunction as a consequence of a cancer treatment. We sought evaluations of interventions that were pharmaceutical, mechanical, psychotherapeutic, complementary or that involved physical exercise. Data collection and analysis Two review authors independently extracted the data and assessed trial quality. We considered meta-analysis for trials with comparable key characteristics. 1 Interventions for sexual dysfunction following treatments for cancer in women (Review)

Talking about women's sexual health after cancer: Why is it so hard to move the needle?

“…45,52 Yet in fact, efficacious treatments for women with cancer-related sexual problems are available and the evidence base is rapidly growing. 41,51,53–56 Physical aids such as vaginal moisturizers and lubricants for sexual intercourse have garnered substantial efficacy data for women who have mild to moderate vaginal dryness and discomfort. 57–60 Such aids can also be helpful in ameliorating more severe sexual problems.…”

“…Telephone-based behavioral interventions could be helpful for reaching patients across a range of ages and levels of internet use and have gained some preliminary evidence in colorectal and breast cancer samples, 66,67 although larger trials of such interventions are needed. Face-to-face group interventions have also gained supporting evidence, 41,68 and are a promising choice for women with access to sexual health programs or similar services at their cancer centers. Community-based sex therapists or other mental health practitioners who have training in treating sexual problems in individual or couple formats can also provide key aspects of sexual rehabilitation for survivors.…”

“…These can be delivered in an individual context (e.g., Brotto’s brief mindfulness-based interventions for female sexual dysfunction), 44,69–71 or in a couple-based context, through partnered sensual touching exercises (i.e., Masters and Johnson-style sensate focus exercises). 41–43,51 Experienced sex therapists are also well-versed in educating clients about how to use personal products such as vibrators which can not only enhance physical pleasure, but also promote physical rehabilitation. 72 In addition, sex therapists can bring a well-spring of experience addressing other distressing issues for survivors such as diminished body image and decreased sexual self-esteem.…”

Supportive care of women with breast cancer: key concerns and practical solutions

“…The impact of cancer and its treatment on sexuality is increasingly recognised. Deleterious changes in sexual function are experienced by 50–70% of women after breast cancer and persist long after diagnosis 21 . Physical sexual side effects of cancer and its treatment may include vaginal atrophy (dryness or tightness), decreased desire or motivation, pain during penetration, absent or muted orgasms, and urinary dysfunction.…”

Peritoneal cavity lavage reduces the presence of mitochondrial damage associated molecular patterns in open abdomen patients

“…These researchers also saw that the inflammatory reaction elicited by sterile mtDAMPs was similar to that elicited by the cecal ligation and puncture model of intraabdominal sepsis. Iyer et al also injected mitochondrial fractions intraperitoneally into mice and induced an inflammatory reaction (10). Furthermore, the researchers inhibited the Nlrp3 inflammasome, a receptor of the innate immune system acted on by mtDAMPs, which mediates pro-inflammatory cytokine release.…”