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Sexual Activity and Function in Patients With Gynecological Malignancies After Completed Treatment
  1. Donata Grimm, MD*,
  2. Annette Hasenburg, MD,
  3. Christine Eulenburg, PhD,
  4. Lisa Steinsiek, MD*,
  5. Sebastian Mayer, MD,
  6. Stephanie Eltrop, MD,
  7. Katharina Prieske, MD*,
  8. Fabian Trillsch, MD*,
  9. Sven Mahner, MD* and
  10. Linn Woelber, MD*
  1. *Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg;
  2. Department of Gynecology and Gynecologic Oncology, University Hospital Freiburg, Freiburg;
  3. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  1. Address correspondence and reprint requests to Linn Woelber, MD, Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. E-mail: lwoelber{at}


Objective Sexual activity (SA) and sexual function (SF) after completion of treatment are central for quality of life (QoL) in women affected by gynecological cancer (GC). The aim of this study was to analyze the sexual outcome and overall QoL of women after treatment for primary GC compared with a healthy control group (CG).

Methods In a multicenter cross-sectional study, 77 women aged 28 to 67 years were surveyed at least 12 months after completion of primary therapy for cervical, endometrial, or vulvar cancer [gynecological cancer group (GCG)]. Data were collected through validated questionnaires (Female Sexual Function Index-d, EORTC Quality of Life Questionnaire-C30, and Sexual Activity Questionnaire) and compared to a control of 60 healthy women (CG).

Results In the GCG, 41.3% were sexually active compared to 78.0% in the CG. Twelve women of the CG and 42 women of the GCG indicated the reasons for their sexual inactivity. The most common reason for sexual inactivity in the GCG was “the-presence-of-a-physical-problem” [18/42 (42.9%) vs 2/12 (16.7%) in the CG], whereas in the CG, “because-I-do-not-have-a-partner” was most common [6/12 (50.0%) vs 11/42 (26.2%) in the GCG]. Sexually active patients in the GCG had an SF comparable to the CG. In multivariate analysis of the total cohort (n = 137), relationship status [solid partnership vs living alone; odds ratio (OR), 33.82; 95% confidence interval (CI), 4.83–236.70], smoking (OR, 0.25; 95% CI, 0.06–1.03), and age (OR, 0.87; 95% CI, 0.79–0.94) influenced SA significantly. The probability of SA thereby decreased with increasing age. Quality of life and subjective general health status were not significantly different between the GCG and the CG (EORTC Quality of Life Questionnaire-C30 score 68.25 vs 69.67).

Conclusions A high number of patients with GC remain sexually inactive after treatment, indicating that women experience persistent functional problems. However, women who regain SA after completed treatment have a good overall SF and vice versa.

  • Gynecological cancer
  • FSFI
  • Sexual activity
  • Sexual function
  • QoL

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  • Supported by internal departmental sources.

  • The authors declare no conflicts of interest.