Sexual Dysfunction Among Cancer Survivors

“Sexual and reproductive health and wellbeing are essential if people are to have responsible, safe and satisfying sexual lives. Sexual health requires a positive approach to human sexuality and an understanding of the complex factors that shape human sexual behaviour. These factors affect whether the expression of sexuality leads to sexual health and wellbeing or to sexual behaviour that put people at risk or make them vulnerable to sexual and reproductive illhealth. Health program managers, policy – makers and care providers need to understand and promote the potentially positive role sexuality can play in peoples’ lives and to build health services that can promote sexually health societies.” – (WHO 2006) There is increasing number of cancer survivors worldwide. A lot of them experience sexual dysfunction for a long time which can last beyond ten years post treatment. Sexual dysfunction can occur as a result of any aspect of cancer and cancer treatment. Sexual functioning and/or satisfaction have been found to be of concern to many cancer survivors. Sexual function can be affected by physical or emotional trauma especially if the genitals are affected and can adversely affect the quality of life of the patients. Sexual dysfunction includes erectile dysfunction in males and disruption in the sexual response cycle (sexual desire, excitement, arousal, orgasm and resolution) and dyspareunia in women. There are differences in the pattern of sexual dysfunction between males and females as females may be able to cope better than males emotionally. Bonini-Colmano et al. (2007) noted that malignant diseases have a strong influence in quality of life, sexuality being one of the most affected variables. In their study to determine the prevalence of sexual dysfunction in a cohort of patients with cancer and its relationship with the following: pain, fatigue, nausea, vomiting, mechanisms of adaptation to stress, anxiety and depression, questionnaires were used which included treatment, adverse events, Zimong and Snaith depression and anxiety scale, sexual dysfunction questionnaire, coping strategies of Tobin David, Hopwood body image scale and the analogical visual test for pain evaluation. Sixty four patients were evaluated. Seventy two percent were women and median age was 50 years. Libido was absent in 50%; this was associated with gender (better in men; p=0,05) and the presence of pain (p=0,05) and fatigue (p=0,05) but not with age. All patients who had intact libido also had arousal and orgasms; this was more prevalent in men than in women and in subjects younger than 60 years. Arousal was absent in 47% of cases. Forty four percent of men had erectile dysfunction; this was present in all patients older than 60 years. Frequency of