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Sexual Health as Part of Gynecologic Cancer Care: What Do Patients Want?
  1. Casey M. Hay, MD*,
  2. Heidi S. Donovan, PhD,
  3. Erin G. Hartnett, MD*,
  4. Jeanne Carter, PhD,
  5. Mary C. Roberge, RN,
  6. Grace B. Campbell, PhD,
  7. Benjamin E. Zuchelkowski, BS§ and
  8. Sarah E. Taylor, MD*
  1. *Division of Gynecologic Oncology, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA;
  2. School of Nursing, University of Pittsburgh, Pittsburgh, PA;
  3. Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY;
  4. §University of Pittsburgh School of Medicine, Pittsburgh, PA.
  1. Address correspondence and reprint requests to Casey M. Hay, MD, Division of Gynecologic Oncology, Magee-Womens Hospital of the University of Pittsburgh Medical Center, 300 Halket St, Pittsburgh, PA 15213. E-mail: chay{at}


Objective Sexual health is important to quality of life; however, the sexual health of gynecologic cancer patients is infrequently and inadequately addressed. We sought to understand patient experiences and preferences for sexual health care to help inform strategies for improvement.

Methods/Materials An anonymous, cross-sectional survey of outpatient gynecologic cancer patients at a large academic medical center was performed as part of a larger study examining patient and caregiver needs. The survey explored patient-provider discussions about sexuality across 3 domains (experiences, preferences, barriers) and 4 phases of cancer care (diagnosis, treatment, treatment completion, follow-up). Age, relationship status, sexual activity, and cancer type were recorded.

Results Mean age was 63 years. Most patients had ovarian cancer (38%) or endometrial cancer (32%). Thirty-seven percent received treatment within the last month, 55% were in a relationship, and 35% were sexuality active. Thirty-four percent reported sexuality as somewhat or very important, whereas 27% felt that it was somewhat or very important to discuss. Importance of sexuality was associated with age, relationship status, and sexual activity but not cancer type. Fifty-seven percent reported never discussing sexuality. Age was associated with sexuality discussions, whereas relationship status, sexual activity, and cancer type were not. The most common barrier to discussion was patient discomfort. Follow-up was identified as the best time for discussion. Sexuality was most often discussed with a physician or advanced practice provider and usually brought up by the provider.

Conclusions Demographic predictors of importance of sexuality to the patient are age, relationship status, and sexual activity. Providers primarily use age as a proxy for importance of sexuality; however, relationship status and sexual activity may represent additional ways to screen for patients interested in discussing sexual health. Patient discomfort with discussing sexuality is the primary barrier to sexual health discussions, and awareness of this is key to developing effective approaches to providing sexual health care.

  • Sexuality
  • Intimacy
  • Sexual health

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  • Research reported in this article was supported by the Magee-Womens Research Institute and the University of Pittsburgh School of Nursing.

  • The authors declare no conflicts of interest.