[Gynecological cancer and sexuality]

Sexual problems and dysfunction after gynecological cancer is frequent, however is still too seldom systematically addressed during consultation. Surgery and adjuvant radiotherapy (external/brachytherapy) and chemotherapy damage neuronal structures and the vaginal tissue and in the case of removal of the ovaries or impairing their function are associated with endocrine changes which impact sexuality. The patient and her partner are challenged to adjust their sexual repertoire to these changes. The success of this adaptation process is partly dependent on individual and relationship factors. The treatment of sexual dysfunction after gynecological cancer includes body oriented (use of dilators, pelvic floor exercises) and pharmacological interventions (a.o. local estrogens, lubricants) and counseling of the patient and the couple.