Purpose
To characterize patients seeking treatment at a Female Sexual Medicine and Women’s Health Program and examine their sexual/vaginal health issues.
Methods
Data from clinical assessment forms were extracted from 509 women referred to the Female Sexual Medicine and Women’s Health Program during/after cancer treatment. The form consists of a Vaginal Assessment Scale [VAS], vaginal health items, patient-reported outcomes (PROs) (Sexual Activity Questionnaire [SAQ], Sexual Self-Schema Scale [SSS], Female Sexual Function Index [FSFI]), and exploratory items.
Results
Of 509 patients, 493 (97%) completed PROs; 253 (50%) received a pelvic examination. The majority had a history of breast (n=260, 51%), gynecologic (n=184, 36%), or colorectal/anal (n=35, 7%) cancer. Mean age was 51.2 years; 313 (62%) were married/partnered. Approximately two-thirds had elevated vaginal pH scores (5–6.5 [35%] or 6.5+ [33%]) and minimal (62%) or no (5%) vaginal moisture. Eighty-seven patients (44%) experienced pain during their exam (23% mild, 11% moderate, 1.5% severe, and 8.5% not indicated). Fifty-three percent engaged in sexual activity with a partner; only 43% felt confident about future sexual activity. Ninety-three percent were somewhat-to-very concerned/worried about sexual function/vaginal health. Approximately half had moderate/severe dryness (n=133, 51%) and dyspareunia (n=120, 46%). Mean SSS score was 60.7, indicating a slightly positive sexual self-view. However, 93.5% (n=429) had an FSFI score <26.55, suggesting sexual dysfunction.
Conclusions
At initial consult, women reported vaginal dryness, pain, and sexual dysfunction. For many women, pelvic exams showed elevated vaginal pH, lack of moisture, and discomfort with the exam itself. Future analyses will examine changes over time.
