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Sexual and Marital Dysfunction in Women With Gynecologic Cancer
  1. Saketh R. Guntupalli, MD*,
  2. Jeanelle Sheeder, PhD, MSPH*,
  3. Yevgeniya Ioffe, MD,
  4. Ana Tergas, MD,
  5. Jason D. Wright, MD,
  6. Susan A. Davidson, MD§,
  7. Kian Behbakht, MD* and
  8. Dina M. Flink, PhD*
  1. *Department of Obstetrics and Gynecology, University of Colorado Cancer Center, Aurora, CO;
  2. Department of Obstetrics and Gynecology, Loma Linda University Cancer Center, Loma Linda, CA;
  3. Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY; and
  4. §Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, CO.
  1. Address correspondence and reprint requests to Saketh R. Guntupalli, MD, 12631 E 17th Ave MS B198-4, Aurora, CO 80045. E-mail:


Objective Sexual dysfunction can be a long-term issue for women with gynecologic cancer. This study assesses the extent of sexual and marital dysfunction women face following treatment of a gynecologic cancer.

Methods A cross-sectional study of women with gynecologic cancer was conducted using a 181-item survey. Sexual dysfunction was measured by change in the Female Sexual Function Index score; marital dysfunction was measured by change in Intimate Bond Measure from prediagnosis to posttreatment. Paired t tests and Fisher exact test were used to compare women with dysfunction to those without dysfunction.

Results Three hundred twenty women were enrolled (mean age, 56.0 [SD, 12.0] years). Among all women, sexual function declined from a score of 21.3 (SD, 10.4) prior to 15.3 (SD, 10.2) (P < 0.001), and sexual activity decreased from 6.1 (SD, 6.8) to 2.6 (SD, 4.9) times per month following treatment (P < 0.001). Among the 208 women who were sexually active at the time of study, sexual dysfunction after treatment was associated with younger age (50.9 [SD, 11.7] years to 57.3 [SD, 12.3] years), ovarian (40.7% vs 30.7%) or cervical (21.0% vs 10.2%) cancer diagnosis, chemotherapy treatment (72.8% vs 50.4%), and being in a relationship (97.3% vs 82.7%). Among women in relationships, 27% experienced marital dysfunction.

Conclusions Women who are younger, have an ovarian or cervical cancer diagnosis, receive chemotherapy, or are in a committed relationship are at particularly high risk of sexual dysfunction. These women should be provided information about the risks associated with their cancer treatment.

  • Cervical cancer
  • Gynecologic cancer
  • Marriage
  • Ovarian cancer
  • Sexual function

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  • This study was funded by the Patty Brisben Foundation, Cincinnati, OH.

  • Final results were presented at the International Gynecologic Cancer Society conference in Lisbon, Portugal; October 29, 2016.

  • The authors declare no conflicts of interest.