Management of sexual dysfunction in breast cancer survivors: a systematic review
Open accessAbstract
Female sexual dysfunction occurs frequently in midlife breast cancer survivors (BCS) and encompasses problems with sexual desire, interest, arousal, orgasm and genitopelvic pain. Although common, sexual problems are under-diagnosed and under-treated in BCS. The objective of this review was to assess primary studies that intervene on sexual dysfunction in BCS. In February 2015, PubMed, SCOPUS, CINAHL, COCHRANE and Web of Science databases were systematically searched for randomized controlled clinical trials (RCTs) of vaginal (lubricants, moisturizers, estrogens, dehydroepiandrosterone [DHEA], testosterone, vibrators, dilators), systemic (androgens, anti-depressants, flibanserin, ospemifene), physical therapy (physical activity, pelvic floor training), counseling and educational interventions on sexual function in BCS. Observational studies of vaginal interventions were also included due to the paucity of RCTs. The search yielded 1414 studies, 34 of which met inclusion criteria. Both interventions and outcomes, measured by 31 different sexual function scales, were heterogeneous, and therefore data were not pooled. The review found that regular and prolonged use of vaginal moisturizers was effective in improving vaginal dryness, dyspareunia, and sexual satisfaction. Educational and counseling interventions targeting sexual dysfunction showed consistent improvement in various aspects of sexual health. No consistent improvements in sexual health were observed with physical activity, transdermal testosterone or hot flash interventions. There was a lack of BCS-specific data on vaginal lubricants, vibrators, dilators, pelvic floor therapy, flibanserin or ospemifene. Overall, the quality of evidence for these studies was moderate to very low. Because each of the interventions with BCS data had limited efficacy, clinical trials to test novel interventions are needed to provide evidence-based clinical recommendations and improve sexual function in BCS.
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Breast cancer treatments and associated side-effects can impair different areas of sexual function via mechanisms such as disrupting ovarian function, body image, intimacy and relationships.
“Breast cancer treatments and associated side-effects can impair different areas of sexual function via a myriad of mechanisms, such as disrupting ovarian function, body image, intimacy and relationships (Paterson et al., 2016; Seav et al., 2015).”
From A guided internet-delivered individually-tailored ACT-influenced cognitive behavioural intervention to improve psychosocial outcomes in breast cancer survivors (iNNOVBC): Study protocol (2019) · cites this paper as Seav et al., 2015
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- Authors
- Seav, S. M., Dominick, S. A., Stepanyuk, B., Gorman, J. R., Chingos, D. T., Ehren, J. L., Krychman, M. L., & Su, H. I.
- Affiliations
- University of California San Diego (US)
- Young Survival Coalition (US)
- University of California, Irvine (US)
- Venue
- Women s Midlife Health
- Published
- 2015-11-02
- Volume
- 1
- Issue
- 1
- Pages
- 9-9
- ISSN
- 2054-2690 (ISSN-L)
- PMC
- PMC6297963
- OpenAlex
- W2199258687
- Cited by
- 59
- References
- 104
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 6 · 2023: 12 · 2022: 7 · 2021: 4 · 2020: 6 · 2019: 6 · 2018: 2 · 2017: 1 · 2016: 1
- FWCI
- 0.18
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Women s Midlife Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Breast Cancer Research Program (120500-PFT-11-008-01-CPPB, HD-058799-01)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- female sexual dysfunction, breast cancer survivors, vaginal dryness, dyspareunia, sexual desire, sexual arousal, orgasm, vaginal moisturizers, vaginal lubricants, flibanserin, ospemifene, testosterone, pelvic floor physiotherapy, counseling intervention, sexual health, middle-aged women
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