Sexual Activity May Reduce Long-Term Side Effects After Cervical Cancer

Engaging in sexual activity or vaginal dilation may lower the risk of developing long-term side effects for patients with cervical cancer, according to findings from an observational study.

“I hope this research helps to reduce the taboo around sexual health and makes it easier for clinicians to discuss these issues with their patients,” Kathrin Kirchheiner, clinical psychologist from the department of radiation oncology at the Medical University of Vienna and lead study author, said in a news release based on a presentation at the American Society for Radiation Oncology (ASTRO) Annual Meeting.

According to American Cancer Society, cervical cancer is a type of gynecologic cancer which forms in the cells lining the cervix, or the lower part of the womb. Over time, normal cells in the cervix could develop abnormal changes, which may become cancer.

The news release stated that a study, EMBRACE, evaluated doctor-reported vaginal side effects and patient-reported outcomes. The study included 1,416 patients with locally advanced cervical cancer and the patients’ median age was 49 years old.

Of the 1,416 total patients in the study, there were 882 patients within a subcohort evaluated by Kirchheiner and the co-authors of the study for side effects in sexually active individuals or individuals who regularly used vaginal dilators in the years following treatment.

“Curing cancer is always our first priority,” Kirchheiner said at the meeting. “But with a growing number of relatively young cervical cancer survivors, the prevention and management of side effects becomes increasingly important to ensure a better quality of life.”

The patients within the study were seen by doctors for 11 follow-up visits to examine any vaginal side effects five years after receiving treatment. During this time, they also completed questionnaires that asked about quality of life, vaginal dilation and sexual activity.

From the questionnaires, 64% of patients reported that engaging in regular vaginal dilation, sexual activity or both was significantly associated with a reduced risk for vaginal stenosis (vaginal shortening and narrowing) of moderate grade 2 or lower five years after receiving treatment, according to the study.

More specifically, 18% of patients in the study reported engaging in both vaginal dilation and sexual activity had the most reduced risk of vaginal stenosis of grade 2 or lower. There were 23% of patients who were sexually active but did not use vaginal dilators and 28% of patients who reported no sexual activity but regularly used vaginal dilators.

Patients who reported no regular use of vaginal dilators or sexual activity (37%) were more likely to experience moderate vaginal stenosis, according to the study.

Although the researchers found that regular sexual activity and use of vaginal dilators reduce the risk of serious vaginal stenosis, this was also associated with an increased risk of milder symptoms, such as vaginal dryness and bleeding, following activity.

“Minor vaginal dryness and bleeding can be managed with lubricants, moisturizer, and/or hormone replacement therapy,” Kirchheiner noted. “The risk of having these minor side effects should not stop patients from dilating or having sexual intercourse, as these activities may help prevent a more serious, and irreversible, condition.”

Vaginal dryness of grade 1 or lower occurred in 72% of patients who reported that they regularly engaged in sexual activity and vaginal dilation, compared with 67% of patients who reported no regular engagement in sexual activity or dilation.

Vaginal bleeding of grade 1 or lower occurred in 61% of patients who regularly engaged in sexual activity or dilation, versus 34% of patients who reported no regular engagement in sexual activity or dilation.

“Sexual health is a highly individual and sensitive topic to address, both in research and in survivorship care, and it deserves a respectful and comprehensive approach,” Kirchheiner said.

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