“Five Years Later…” Psychosexual Adjustment Following Treatment For Various Gynaecological Conditions

Psychosexual outcomes of early stage cervical and endometrial cancer (N=53) were compared with the outcomes of patients treated for benign gynaecological conditions (N=60) and pre-invasive cervical abnormalities (N=84). All women were assessed at baseline, 6 months, 12 months (cancer group only) and 5 years post-treatment, using standardised measures.
The 6 and 12 months follow up data suggested that treatment for cervical and endometrial cancer did not result in major, continuing sexual upheaval and sequelae. Despite many irrevocable adverse vaginal changes and treatment side effects, and a temporary decline in sexual drive and overt sexual behaviours, the only lasting decline was seen in sexual satisfaction (p=0.006). The key predictors of post-treatment psychosexual adjustment were psychological factors (p=0.011) and the doctor-patient relationship (p=0.023). Anxiety levels remained elevated in approximately a third of patients in all groups. Only half of cancer patients (53%) had discussions about sexual matters with their oncologists and of particular concern was the alarmingly low number of patients aware of the existence of vaginal dilators. The presence of myths and misconceptions regarding contagiousness of cancer was noted in a small but significant minority of patients (5%) and partners (9%). Patients treated for non-oncological gynaecological conditions reported poorer adjustment to their diagnosis and treatment than expected. Five-year follow up results will be also discussed. These findings have important implications for clinical practice and future research.