Vaginal and sexual health treatment strategies within a female sexual medicine program for cancer patients and survivors Journal Article


Authors: Carter, J.; Stabile, C.; Seidel, B.; Baser, R. E.; Goldfarb, S.; Goldfrank, D. J.
Article Title: Vaginal and sexual health treatment strategies within a female sexual medicine program for cancer patients and survivors
Abstract: Purpose: We sought to evaluate patient adherence and response to simple vaginal and sexual health treatment strategies in female cancer patients receiving treatment at a female sexual medicine and health program and identify improvements of physical symptoms, per patient and clinical evaluation. Methods: Evaluability criteria included gynecologic exam at initial visit, at least one follow-up with gynecologic exam within 8 months of initial visit, and all consecutive follow-ups <6 months apart. Demographics, medical information, and clinical assessments from 175 evaluable patients with at least one follow-up from 09/12 to 10/14 were analyzed. The majority of patients were being treated for or had a history of breast (n = 90, 53 %), gynecologic (n = 54, 32 %), or colorectal/anal (n = 15, 9 %) cancers. An assessment form included a clinician evaluation, Vaginal Assessment Scale (VAS), Vulvar Assessment Scale (VuAS), and patient-reported outcomes. Compliance with treatment recommendations were summarized, and changes over time were compared for clinical outcomes. Results: Mean number of visits was 3.43. Mean age was 55.4 years; 92 % (n = 155/169) were in menopause. Treatment strategies included rationale and instruction for use of vaginal moisturizers, lubricants, pelvic floor exercises, and dilator therapy, in addition to psychosexual education regarding sexual changes (response, anatomy, and function) associated with cancer treatment and support. At last assessment, 89 % had complied with the clinical recommendation (moisturize 2–5+ times/week). Vaginal pH scores >6.5 declined over time (p = 0.03). VAS scores improved by last assessment (p < 0.001), as did VuAS scores (p = 0.001). Sexual function scores significantly improved (p < 0.001), confidence about future sexual activity increased (p = 0.004), and sexual/vaginal health concerns decreased (p = 0.00003). Conclusion: Significant changes were observed in women using treatment strategies, with improvement in vulvovaginal symptoms, a decrease in elevated vaginal pH and pain with exams, enhanced sexual function, and increased intimacy confidence. Implications for Cancer Survivors: These findings have high clinical relevance for symptom management with improvement of sexual function using simple strategies and clinical tools in the oncology setting. © 2016, Springer Science+Business Media New York.
Keywords: quality of life; survivorship; vaginal health; female sexual health; cancer
Journal Title: Journal of Cancer Survivorship
Volume: 11
Issue: 2
ISSN: 1932-2259
Publisher: Springer  
Date Published: 2017-04-01
Start Page: 274
End Page: 283
Language: English
DOI: 10.1007/s11764-016-0585-9
PROVIDER: scopus
PMCID: PMC5357589
PUBMED: 27868156
DOI/URL:
Notes: Article -- Export Date: 4 April 2017 -- Source: Scopus
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  1. Raymond E Baser
    133 Baser
  2. Jeanne Carter
    159 Carter
  3. Shari Goldfarb
    149 Goldfarb
  4. Cara Marie Stabile
    26 Stabile
  5. Barbara A Seidel
    12 Seidel