Interventions for sexual problems following treatment for breast cancer: a systematic review

Abstract

Sexual functioning is an important element of quality of life. Many women experience sexual problems as a result of a breast cancer diagnosis and its treatment. Little is known about the availability and the effectiveness of interventions for sexual problems in this patient population. Six electronic databases were searched using Medical Subject Headings and keywords. Additional hand searching of the references of relevant papers was also conducted. The searches were conducted between October 2010 and January 2011. Papers were included if they evaluated interventions for sexual problems caused as a result of breast cancer or its treatment. Studies were only included if sexual functioning was reported using a patient-reported outcome questionnaire. Studies were excluded if sexual functioning was measured but improving sexual problems was not one of the main aims of the intervention. 3514 papers were identified in the initial search. 21 papers were selected for inclusion. Studies were of mixed methodological quality; 15 randomised trials were identified, many included small sample sizes and the use of non-validated questionnaires. Three main types of interventions were identified: Exercise (2), medical (2) and psycho-educational (17). The psycho-educational interventions included skills-based training such as problem-solving and communication skills, counselling, hypnosis, education and specific sex-therapies. Interventions were delivered to individual patients, patients and their partners (couple-based) and groups of patients. The widespread methodological variability hinders the development of a coherent picture about which interventions work for whom. Tentative findings suggest the most effective interventions are couple-based psycho-educational interventions that include an element of sexual therapy. More methodologically strong research is needed before any intervention can be recommended for clinical practice. Improved screening and classification of sexual problems will ensure interventions can be more effectively targeted to suit individual patient needs.

A clinical guide to the management of genitourinary symptoms in breast cancer survivors on endocrine therapy

“…Nonetheless, the study also highlighted that such therapies are unlikely to reduce sexually-related distress [Hickey et al 2016]. In a systematic review specifically addressing interventions for sexual problems following breast cancer, it was suggested, that the most effective intervention for this issue was couple-based psycho-educational interventions that include an element of sexual therapy, although this was based on moderate evidence of its effectiveness [Taylor et al 2011]. A new approach to dyspareunia involves the application of aqueous lidocaine prior to penetration, which potentially acts on reducing pain in the vulvar vestibule (i.e.…”

Interventions to Address Sexual Problems in People with Cancer

“…The current evidence does not support a specific psychosocial counselling intervention to improve sexual functioning and satisfaction. The evidence base for this recommendation consists of sixteen publications of moderate quality [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] and four systematic reviews [14][15][16][17] . …”

“…A handful of systematic reviews have been published [12][13][14][15][16][17][18][19] , but they tend to focus on a single cancer or intervention type. No guidelines have comprehensively addressed sexual issues in people with cancer.…”

Survivorship Care Plans for Breast Cancer Patients: Understanding the Quality of the Available Evidence

“…Of the eight scientific reviews 40,[60][61][62][73][74][75][76][77] that reported the effects of psychoeducational interventions such as cognitive-behavioural techniques or education for bca patients and survivors, one 61 reported statistically significant benefits for fatigue (p < 0.001), depression (p < 0.001), anxiety (p < 0.001), and body image (p < 0.051). Two reviews found clinically important benefits for anxiety, depression, and stress levels with moderate-intensity activity 60,73 ; one reported benefits for mobility, muscle strength, and general fitness, and clinically important benefits for sexual functioning 62 ; four reported short-term benefits for overall survival with low-intensity activity, and also improvements in mood and pain reduction [74][75][76][77] ; and yet another reported significant reductions in fatigue, nausea, oral mucositis, diarrhea, constipation, pain, and insomnia, and improved qol 60 .…”

“…Two reviews found clinically important benefits for anxiety, depression, and stress levels with moderate-intensity activity 60,73 ; one reported benefits for mobility, muscle strength, and general fitness, and clinically important benefits for sexual functioning 62 ; four reported short-term benefits for overall survival with low-intensity activity, and also improvements in mood and pain reduction [74][75][76][77] ; and yet another reported significant reductions in fatigue, nausea, oral mucositis, diarrhea, constipation, pain, and insomnia, and improved qol 60 .…”