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For cervical cancer survivors, it can be difficult to adjust to changes in sexuality. Pain, poor lubrication, and anxiety are common issues, and it takes time to feel comfortable with sex again. For some women, the situation causes great distress. In fact, a recent study published in the journal Psycho-Oncology estimates that about a third of cervical cancer survivors feel sexual distress.
Cervical cancer affects the cervix, a short cylinder-shaped organ that connects the uterus and the vagina. Typically, the cervix contains mucus that protects the uterus from bacteria. Once a month, when a woman ovulates, the mucus becomes thinner, allowing for more sperm to pass through and fertilize the egg.
The American Cancer Society estimates that over 13,000 cases of cervical cancer will be diagnosed in the United States in 2018.
Women with cervical cancer may have several treatment options, including radiation therapy, chemotherapy, and surgery. These treatments can affect other organs, like the vagina, uterus, ovaries, fallopian tubes, and lymph nodes. Sometimes, the treatments affect a woman’s sexual function.
For example, surgery and chemotherapy can induce early menopause, lowering levels of estrogen, a hormone that keeps the vagina healthy. Radiation might lead to vaginal shortening.
The Psycho-Oncology study involved 194 sexually-active women between the ages of 25 and 69 (average age 46) in the Netherlands. All were cervical cancer survivors. The women completed questionnaires about their sexual relationship, including how much sexual distress they felt and how much they worried about sexual pain. They also answered questions about body image, vaginal symptoms, relationship satisfaction, anxiety, and depression.
Thirty-three percent of the women met the criteria for sexual distress. More specifically, the researchers found that sexual distress was linked to worries about sexual pain, vaginal sexual symptoms, relationship dissatisfaction, and body image concerns.
In addition, women who worried about sexual pain tended to have vaginal symptoms and sexual distress. It’s possible that women who feared pain were so focused on the expectation of pain that they couldn’t become aroused and lubricated enough for intercourse. Poor lubrication is a cause of sexual pain, which can increase distress levels.
If you’re facing sexual challenges from cervical cancer – or any type of cancer – be sure to talk to your cancer care team, your gynecologist, or your primary healthcare provider. Many problems can be treated. For example, a lubricant or moisturizer might relieve vaginal dryness and make sex more comfortable. Women who fear pain or feel anxious or depressed by benefit from counseling or sex therapy.
Resources
American Cancer Society
“Lymph Nodes and Cancer”
(Last revised: April 14, 2015)
https://www.cancer.org/cancer/cancer-basics/lymph-nodes-and-cancer.html
“What Is Cervical Cancer?”
(Last revised: December 5, 2016)
https://www.cancer.org/cancer/cervical-cancer/about/what-is-cervical-cancer.html
Canadian Cancer Society
“Anatomy and physiology of the cervix”
http://www.cancer.ca/en/cancer-information/cancer-type/cervical/cervical-cancer/the-cervix/?region=on
“Treatments for cervical cancer”
http://www.cancer.ca/en/cancer-information/cancer-type/cervical/treatment/?region=on
Contemporary OB/GYN
Monson, Nancy
“Cervical Cancer Survivors Have High Scores for Sexual Distress”
(February 14, 2018)
http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/news/cervical-cancer-survivors-have-high-scores-sexual-distress
Psycho-Oncology
Bakker, R.M., et al.
“Sexual distress and associated factors among cervical cancer survivors: A cross‐sectional multicenter observational study”
(Abstract. First published: November 15, 2016)
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