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Sexual dysfunction is an extremely common issue for women who have gone through cancer treatment, though the topic may be difficult for some to talk about.
Dr. Janelle Sobecki, a gynecologic oncologist and medical director for the Women's Integrative Sexual Health (WISH) program at UW Health, wants to empower more female cancer survivors to seek out their options for improved sexual health and better quality of life.
“The best research we have indicates 40-70% of women have a sexual side effect related to their cancer treatment,” Sobecki said.
The WISH program was created about 10 years ago to provide clinical consultation, resources, education, emotional support and appropriate referrals for women whose sexual health has been impacted by cancer treatments.
Sobecki said there has been increased attention on researching and treating these side effects in recent years, especially for women. She’s encouraged by new research work underway, including WISH’s data-sharing and collaboration with a similar program at the University of Chicago called Program in Integrative Sexual Medicine for Women and Girls with Cancer as well as the Scientific Network on Female Sexual Health and Cancer. WISH also invites its patients to participate in a patient registry database to further aid this work.
Sexual side effects can be caused by treatment for any cancer type, according to Sobecki. These issues can arise during treatment as well as months or years later. For women who are partnered, these issues can also affect their partners and their relationships.
Side effects can include loss of sensation in sexual organs, pain, lack of interest in sex, scar tissue and dryness in the vulva and vagina, difficulty achieving orgasm and diminished pleasure of an orgasm. Sexual organs are also removed during treatment for certain cancers, such as breast and some gynecologic cancers. Intense fatigue, changes in mental health, skin sensitivity and body image issues can also impact a woman’s desire for sex.
Sobecki encourages any woman dealing with these issues to ask for help.
“There are probably many women who don’t recognize this is something they can bring up to their doctor,” she said. “Sexual problems are common for women with cancer and addressing them is really important for improving quality of life. We’re lucky that UW Health and the Carbone Cancer Center supports a clinic like WISH so we can help women suffering with these issues.”
New patients to WISH have an initial 60-minute consultation with a provider, focused on getting to know the patient, answering questions and providing education. This visit can be done through a telemedicine visit for women in Wisconsin and Illinois, which offers more convenience to patients who are farther from Madison.
The second visit includes a physical exam as well as discussions of treatment options, which can include vaginal moisturizers and lubricants, vaginal dilator therapy, pelvic floor physical therapy, and a referral for a sex therapist.
Sobecki is also working on education among fellow health care providers to encourage them to ask patients about any sexual health concerns related to their cancer treatment, as well as integrating those questions into screening or pre-exam intake forms. For some patients, it’s easier to have their doctor bring it up than volunteer questions on their own. It also can help avoid the “doorknob questions,” where these issues are brought up at the end of an appointment when time is limited.
“We need to put sexual health changes at the forefront of the survivorship conversation, so there’s time to discuss and give it the attention it deserves,” Sobecki said.