Management of sexuality, intimacy, and menopause symptoms in patients with ovarian cancer

• Published in: American journal of obstetrics and gynecology Vol. 217; no. 4; pp. 395 - 403
• Main Authors: Whicker, Margaret, MD, Black, Jonathan, MD, Altwerger, Gary, MD, Menderes, Gulden, MD, Feinberg, Jacqueline, MD, Ratner, Elena, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2017
• Subjects: Administration, Topical; Anabolic Agents - therapeutic use; Body Image; Cognitive Therapy; Depression - physiopathology; Depression - psychology; Estrogen Antagonists - therapeutic use; Estrogens - administration & dosage; Fatigue - physiopathology; Fatigue - psychology; Female; Hormone Replacement Therapy; Humans; intimacy; Lubricants - therapeutic use; menopause; Menopause, Premature - physiology; Menopause, Premature - psychology; Norpregnenes - therapeutic use; Obstetrics and Gynecology; ovarian cancer; Ovarian Neoplasms - physiopathology; Ovarian Neoplasms - psychology; Ovarian Neoplasms - therapy; Pelvic Floor Disorders - rehabilitation; Physical Therapy Modalities; Phytotherapy; Quality of Life; Serotonin Uptake Inhibitors - therapeutic use; Sexual Dysfunction, Physiological - therapy; Sexual Dysfunctions, Psychological - therapy; Sexuality; Tamoxifen - analogs & derivatives; Tamoxifen - therapeutic use; Testosterone - therapeutic use; intimacy; menopause; sexuality; ovarian cancer
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2017.04.012

Issues of sexuality, intimacy, and early menopause significantly impact the quality of life of patients following the diagnosis and treatment of ovarian cancer. These are undertreated problems. Successful treatment requires the provider’s awareness of the problem, ability to identify it, and willingness to treat it. Unfortunately many providers do not address these issues in the pretreatment or perioperative period. Furthermore, patients do not often alert their providers to their symptoms. While systemic hormone therapy may improve many of the issues, they are not appropriate for all patients given their action on estrogen receptors. However, other nonhormonal treatments exist including selective serotonin reuptake inhibitors, antiepileptics, natural remedies, and pelvic floor physical therapy. In addition psychological care and the involvement of the partner can be helpful in managing the sexual health concerns of these patients. At the time of diagnosis or at initial consultation, women should be informed of the potential physiologic, hormonal, and psychosocial effects of ovarian cancer on sexuality and that there is a multimodal approach to dealing with symptoms.