Perceived causes and consequences of sexual changes after cancer for women and men: a mixed method study
Research article
1 Centre for Health Research, University of Western Sydney, Locked Bag 1797, Penrith South 2751, Australia
2 School of Social Sciences and Psychology, University of Western Sydney, Locked Bag 1797, Penrith South 2751, Australia
BMC Cancer 2015, 15:268Â
doi:10.1186/s12885-015-1243-8
Published: 11 April 2015
Abstract (provisional)
Background Previous research on cancer and sexuality has focused on physical aspects
of sexual dysfunction, neglecting the subjective meaning and consequences of sexual
changes. This has led to calls for research on cancer and sexuality to adopt an “integrativeâ€
approach, and to examine the ways in which individuals interpret sexual changes, and
the subjective consequences of sexual changes. Method This study examined the nature
and subjective experience and consequences of changes to sexual well-being after cancer,
using a combination of quantitative and qualitative analysis. Six hundred and fifty
seven people with cancer (535 women, 122 men), across a range of reproductive and
non-reproductive cancer types completed a survey and 44 (23 women, 21 men) took part
in an in-depth interview. Results Sexual frequency, sexual satisfaction and engagement
in a range of penetrative and non-penetrative sexual activities were reported to have
reduced after cancer, for both women and men, across reproductive and non-reproductive
cancer types. Perceived causes of such changes were physical consequences of cancer
treatment, psychological factors, body image concerns and relationship factors. Sex
specific difficulties (vaginal dryness and erectile dysfunction) were the most commonly
reported explanation for both women and men, followed by tiredness and feeling unattractive
for women, and surgery and getting older for men. Psychological and relationship factors
were also identified as consequence of changes to sexuality. This included disappointment
at loss of sexual intimacy, frustration and anger, sadness, feelings of inadequacy
and changes to sense of masculinity of femininity, as well as increased confidence
and self-comfort; and relationship strain, relationship ending and difficulties forming
a new relationship. Conversely, a number of participants reported increased confidence,
re-prioritisation of sex, sexual re-negotiation, as well as a strengthened relationship,
after cancer. Conclusion The findings of this study confirm the importance of health
professionals and support workers acknowledging sexual changes when providing health
information and developing supportive interventions, across the whole spectrum of
cancer care. Psychological interventions aimed at reducing distress and improving
quality of life after cancer should include a component on sexual well-being, and
sexual interventions should incorporate components on psychological and relational
functioning.