title: Maintaining sexual health throughout gynecologic cancer survivorship: A comprehensive review and clinical guide.
abstract: OBJECTIVE
  The diagnosis and treatment of gynecologic cancer can cause short- and long-term negative effects on sexual health and quality of life (QoL). The aim of this article is to present a comprehensive overview of the sexual health concerns of gynecologic cancer survivors and discuss evidence-based treatment options for commonly encountered sexual health issues.
  
  
  METHODS
  A comprehensive literature search of English language studies on sexual health in gynecologic cancer survivors and the treatment of sexual dysfunction was conducted in MEDLINE databases. Relevant data are presented in this review. Additionally, personal and institutional practices are incorporated where relevant.
  
  
  RESULTS
  Sexual dysfunction is prevalent among gynecologic cancer survivors as a result of surgery, radiation, and chemotherapy-negatively impacting QoL. Many patients expect their healthcare providers to address sexual health concerns, but most have never discussed sex-related issues with their physician. Lubricants, moisturizers, and dilators are effective, simple, non-hormonal interventions that can alleviate the morbidity of vaginal atrophy, stenosis, and pain. Pelvic floor physical therapy can be an additional tool to address dyspareunia. Cognitive behavioral therapy has been shown to be beneficial to patients reporting problems with sexual interest, arousal, and orgasm.
  
  
  CONCLUSIONS
  Oncology providers can make a significant impact on the QoL of gynecologic cancer survivors by addressing sexual health concerns. Simple strategies can be implemented into clinical practice to discuss and treat many sexual issues. Referral to specialized sexual health providers may be needed to address more complex problems.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Huffman
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Hartenbach
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, United States; Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, United States.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Carter
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
authors.forename: Joanne K
authors.initials: JK
authors.lastname: Rash
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The University of Wisconsin School of Medicine and Public Health, Madison, WI, United States. Electronic address: DMKushner@wisc.edu.
authors.forename: David M
authors.initials: DM
authors.lastname: Kushner
mesh_terms: D005260:Female; D005833:Genital Neoplasms, Female / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*
keywords: Female sexual dysfunction; Gynecologic cancer; Quality of life; Sexual health