Sexual Health after a Breast Cancer Diagnosis: Addressing a Forgotten Aspect of Survivorship

Suneela Vegunta, Carol L Kuhle, Jennifer A Vencill, Pauline H Lucas, Dawn M Mussallem, Suneela Vegunta, Carol L Kuhle, Jennifer A Vencill, Pauline H Lucas, Dawn M Mussallem

Abstract

Breast cancer is the most common cancer in women. The life expectancy after a breast cancer diagnosis is improving steadily, leaving many more persons with the long-term consequences of treatment. Sexual problems are a common concern for breast cancer survivors yet remain overlooked in both the clinical setting and the research literature. Factors that contribute to sexual health concerns in breast cancer survivors are biopsychosocial, as are the barriers to addressing and treating these health concerns. Sexual health needs and treatment may vary by anatomy and gender. Multidisciplinary management may comprise lifestyle modifications, medications, sexual health aids such as vibrators, counseling, and referrals to pelvic health physical therapy and specialty care. In this article, we review the contributing factors, screening, and management of sexual difficulties in cisgender female breast cancer survivors. More information is needed to better address the sexual health of breast cancer survivors whose sexual/gender identity differs from that of cisgender women.

Keywords: preventative/mitigation strategies; risk factors and risk prediction; sexual dysfunction.

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Miller K.D., Nogueira L., Mariotto A.B., Rowland J.H., Yabroff K.R., Alfano C.M., Jemal A., Kramer J.L., Siegel R.L. Cancer treatment and survivorship statistics, 2019. CA Cancer J. Clin. 2019;69:363–385. doi: 10.3322/caac.21565.
    1. National Cancer Institute Cancer Stat Facts: Female Breast Cancer. U.S. Department of Health and Human Services. [(accessed on 16 September 2015)]; Available online: .
    1. American Cancer Society Cancer Treatment & Survivorship Facts & Figures 2014–2015. [(accessed on 19 May 2015)]. Available online: .
    1. Midding E., Halbach S.M., Kowalski C., Weber R., Wurstlein R., Ernstmann N. Men With a “Woman’s Disease”: Stigmatization of Male Breast Cancer Patients-A Mixed Methods Analysis. Am. J. Mens Health. 2018;12:2194–2207. doi: 10.1177/1557988318799025.
    1. Deutsch M.B., Radix A., Wesp L. Breast Cancer Screening, Management, and a Review of Case Study Literature in Transgender Populations. Semin Reprod. Med. 2017;35:434–441. doi: 10.1055/s-0037-1606103.
    1. Clarke C.N., Cortina C.S., Fayanju O.M., Dossett L.A., Johnston F.M., Wong S.L. Breast Cancer Risk and Screening in Transgender Persons: A Call for Inclusive Care. Ann. Surg. Oncol. 2022;29:2176–2180. doi: 10.1245/s10434-021-10217-5.
    1. Stone J.P., Hartley R.L., Temple-Oberle C. Breast cancer in transgender patients: A systematic review. Part 2: Female to Male. Eur. J. Surg Oncol. 2018;44:1463–1468. doi: 10.1016/j.ejso.2018.06.021.
    1. Hartley R.L., Stone J.P., Temple-Oberle C. Breast cancer in transgender patients: A systematic review. Part 1: Male to female. Eur. J. Surg Oncol. 2018;44:1455–1462. doi: 10.1016/j.ejso.2018.06.035.
    1. Younas A., Sundus A., Inayat S. Transitional experience of men with breast cancer from diagnosis to survivorship: An integrative review. Eur. J. Oncol. Nurs. 2019;42:141–152. doi: 10.1016/j.ejon.2019.09.005.
    1. Co M., Lee A., Kwong A. Delayed presentation, diagnosis, and psychosocial aspects of male breast cancer. Cancer Med. 2020;9:3305–3309. doi: 10.1002/cam4.2953.
    1. Vencill J.A., Kacel E.L., Avulova S., Ehlers S.L. Barriers to sexual recovery in women with urologic cancers. Urol. Oncol. 2020;40:372–378. doi: 10.1016/j.urolonc.2020.11.011.
    1. Panjari M., Davis S.R., Fradkin P., Bell R.J. Breast cancer survivors’ beliefs about the causes of breast cancer. Psychooncology. 2012;21:724–729. doi: 10.1002/pon.1949.
    1. Sadovsky R., Basson R., Krychman M., Morales A.M., Schover L., Wang R., Incrocci L. Cancer and sexual problems. J. Sex Med. 2010;7:349–373. doi: 10.1111/j.1743-6109.2009.01620.x.
    1. Nappi R.E., Cucinella L., Martella S., Rossi M., Tiranini L., Martini E. Female sexual dysfunction (FSD): Prevalence and impact on quality of life (QoL) Maturitas. 2016;94:87–91. doi: 10.1016/j.maturitas.2016.09.013.
    1. Pumo V., Milone G., Iacono M., Giuliano S.R., Di Mari A., Lopiano C., Bordonaro S., Tralongo P. Psychological and sexual disorders in long-term breast cancer survivors. Cancer Manag. Res. 2012;4:61–65. doi: 10.2147/CMAR.S28547.
    1. Bober S.L., Kingsberg S.A., Faubion S.S. Sexual function after cancer: Paying the price of survivorship. Climacteric. 2019;22:558–564. doi: 10.1080/13697137.2019.1606796.
    1. Canzona M.R., Ledford C.J.W., Fisher C.L., Garcia D., Raleigh M., Kalish V.B. Clinician barriers to initiating sexual health conversations with breast cancer survivors: The influence of assumptions and situational constraints. Fam. Syst. Health. 2018;36:20–28. doi: 10.1037/fsh0000307.
    1. Canzona M.R., Fisher C.L., Ledford C.J.W. Perpetuating the cycle of silence: The intersection of uncertainty and sexual health communication among couples after breast cancer treatment. Support. Care Cancer. 2019;27:659–668. doi: 10.1007/s00520-018-4369-9.
    1. Wysocki S., Kingsberg S., Krychman M. Management of Vaginal Atrophy: Implications from the REVIVE Survey. Clin. Med. Insights Reprod. Health. 2014;8:23–30. doi: 10.4137/CMRH.S14498.
    1. Levin R., Meston C. Nipple/Breast stimulation and sexual arousal in young men and women. J. Sex Med. 2006;3:450–454. doi: 10.1111/j.1743-6109.2006.00230.x.
    1. Lindau S.T., Bensmaia S.J. Using Bionics to Restore Sensation to Reconstructed Breasts. Front. Neurorobot. 2020;14:24. doi: 10.3389/fnbot.2020.00024.
    1. Streicher L., Simon J.A. Sexual Function Post-Breast Cancer. Cancer Treat. Res. 2018;173:167–189. doi: 10.1007/978-3-319-70197-4_11.
    1. Christie K.M., Meyerowitz B.E., Maly R.C. Depression and sexual adjustment following breast cancer in low-income Hispanic and non-Hispanic White women. Psychooncology. 2010;19:1069–1077. doi: 10.1002/pon.1661.
    1. Imprialos K.P., Stavropoulos K., Doumas M., Tziomalos K., Karagiannis A., Athyros V.G. Sexual Dysfunction, Cardiovascular Risk and Effects of Pharmacotherapy. Curr Vasc Pharmacol. 2018;16:130–142. doi: 10.2174/1570161115666170609101502.
    1. Gabrielson A.T., Sartor R.A., Hellstrom W.J.G. The Impact of Thyroid Disease on Sexual Dysfunction in Men and Women. Sex Med. Rev. 2019;7:57–70. doi: 10.1016/j.sxmr.2018.05.002.
    1. Winkley K., Kristensen C., Fosbury J. Sexual health and function in women with diabetes. Diabet Med. 2021;38:e14644. doi: 10.1111/dme.14644.
    1. Maiorino M.I., Bellastella G., Castaldo F., Petrizzo M., Giugliano D., Esposito K. Sexual function in young women with type 1 diabetes: The METRO study. J. Endocrinol. Investig. 2017;40:169–177. doi: 10.1007/s40618-016-0542-5.
    1. Montorsi F., Adaikan G., Becher E., Giuliano F., Khoury S., Lue T.F., Sharlip I., Althof S.E., Andersson K.E., Brock G., et al. Summary of the recommendations on sexual dysfunctions in men. J. Sex Med. 2010;7:3572–3588. doi: 10.1111/j.1743-6109.2010.02062.x.
    1. Anders C.K., Fan C., Parker J.S., Carey L.A., Blackwell K.L., Klauber-DeMore N., Perou C.M. Breast carcinomas arising at a young age: Unique biology or a surrogate for aggressive intrinsic subtypes? J. Clin. Oncol. 2011;29:e18–e20. doi: 10.1200/JCO.2010.28.9199.
    1. Hungr C., Recklitis C.J., Wright A.A., Bober S.L. How does a single session group intervention improve sexual function in ovarian cancer survivors? A secondary analysis of effects of self-efficacy, knowledge and emotional distress. Psychol. Health Med. 2020;25:110–120. doi: 10.1080/13548506.2019.1626452.
    1. Panjari M., Bell R.J., Davis S.R. Sexual function after breast cancer. J. Sex Med. 2011;8:294–302. doi: 10.1111/j.1743-6109.2010.02034.x.
    1. Loaring J.M., Larkin M., Shaw R., Flowers P. Renegotiating sexual intimacy in the context of altered embodiment: The experiences of women with breast cancer and their male partners following mastectomy and reconstruction. Health Psychol. 2015;34:426–436. doi: 10.1037/hea0000195.
    1. Telli S., Gurkan A. Examination of Sexual Quality of Life and Dyadic Adjustment among Women with Mastectomy. Eur. J. Breast Health. 2020;16:48–54. doi: 10.5152/ejbh.2019.4969.
    1. Tarkowska M., Glowacka-Mrotek I., Nowikiewicz T., Monastyrska-Waszak E., Gastecka A., Goch A., Zegarski W. Sexual functioning and self-esteem in women after mastectomy—A single-centre, non-randomised, cross-sectional study. Contemp. Oncol. 2020;24:106–111. doi: 10.5114/wo.2020.95876.
    1. Gong Y., Tan Q., Qin Q., Wei C. Prevalence of postmastectomy pain syndrome and associated risk factors: A large single-institution cohort study. Medicine. 2020;99:e19834. doi: 10.1097/MD.0000000000019834.
    1. Gass J.S., Onstad M., Pesek S., Rojas K., Fogarty S., Stuckey A., Raker C., Dizon D.S. Breast-Specific Sensuality and Sexual Function in Cancer Survivorship: Does Surgical Modality Matter? Ann. Surg. Oncol. 2017;24:3133–3140. doi: 10.1245/s10434-017-5905-4.
    1. Aerts L., Christiaens M.R., Enzlin P., Neven P., Amant F. Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: A prospective controlled study. Breast. 2014;23:629–636. doi: 10.1016/j.breast.2014.06.012.
    1. Dossett L.A., Lowe J., Sun W., Lee M.C., Smith P.D., Jacobsen P.B., Laronga C. Prospective evaluation of skin and nipple-areola sensation and patient satisfaction after nipple-sparing mastectomy. J. Surg. Oncol. 2016;114:11–16. doi: 10.1002/jso.24264.
    1. Wei C.H., Scott A.M., Price A.N., Miller H.C., Klassen A.F., Jhanwar S.M., Mehrara B.J., Disa J.J., McCarthy C., Matros E., et al. Psychosocial and Sexual Well-Being Following Nipple-Sparing Mastectomy and Reconstruction. Breast J. 2016;22:10–17. doi: 10.1111/tbj.12542.
    1. Yoon-Flannery K., DeStefano L.M., De La Cruz L.M., Fisher C.S., Lin L.Y., Coffua L.S., Mustafa R.E., Sataloff D.M., Tchou J.C., Brooks A.D. Quality of life and sexual well-being after nipple sparing mastectomy: A matched comparison of patients using the breast Q. J. Surg. Oncol. 2018;118:238–242. doi: 10.1002/jso.25107.
    1. Bykowski M.R., Emelife P.I., Emelife N.N., Chen W., Panetta N.J., de la Cruz C. Nipple-areola complex reconstruction improves psychosocial and sexual well-being in women treated for breast cancer. J. Plast. Reconstr. Aesthet. Surg. 2017;70:209–214. doi: 10.1016/j.bjps.2016.10.009.
    1. Gillespie T.C., Sayegh H.E., Brunelle C.L., Daniell K.M., Taghian A.G. Breast cancer-related lymphedema: Risk factors, precautionary measures, and treatments. Gland Surg. 2018;7:379–403. doi: 10.21037/gs.2017.11.04.
    1. Mulkoglu C., Ayhan F., Erel S. Sexual Functions and Quality of Life in Patients Developing Lymphedema After Total Mastectomy: A Pilot Study. Lymphat. Res. Biol. 2022;20:220–227. doi: 10.1089/lrb.2020.0053.
    1. Faubion S.S., Kuhle C.L., Shuster L.T., Rocca W.A. Long-term health consequences of premature or early menopause and considerations for management. Climacteric. 2015;18:483–491. doi: 10.3109/13697137.2015.1020484.
    1. Ochsenkuhn R., Hermelink K., Clayton A.H., von Schonfeldt V., Gallwas J., Ditsch N., Rogenhofer N., Kahlert S. Menopausal status in breast cancer patients with past chemotherapy determines long-term hypoactive sexual desire disorder. J. Sex Med. 2011;8:1486–1494. doi: 10.1111/j.1743-6109.2011.02220.x.
    1. Marino J.L., Saunders C.M., Emery L.I., Green H., Doherty D.A., Hickey M. How does adjuvant chemotherapy affect menopausal symptoms, sexual function, and quality of life after breast cancer? Menopause. 2016;23:1000–1008. doi: 10.1097/GME.0000000000000664.
    1. Cavalheiro J.A., Bittelbrunn A., Menke C.H., Biazus J.V., Xavier N.L., Cericatto R., Schuh F., Pinheiro C.V., Passos E.P. Sexual function and chemotherapy in postmenopausal women with breast cancer. BMC Womens Health. 2012;12:28. doi: 10.1186/1472-6874-12-28.
    1. Pearson A., Booker A., Tio M., Marx G. Vaginal CO2 laser for the treatment of vulvovaginal atrophy in women with breast cancer: LAAVA pilot study. Breast Cancer Res. Treat. 2019;178:135–140. doi: 10.1007/s10549-019-05384-9.
    1. Bober S.L., Carter J., Falk S. Addressing female sexual function after cancer by internists and primary care providers. J. Sex Med. 2013;10((Suppl. 1)):112–119. doi: 10.1111/jsm.12027.
    1. Kim N., Chang J.S., Shah C., Shin H., Keum K.C., Suh C.O., Kim Y.B. Hypofractionated volumetric-modulated arc therapy for breast cancer: A propensity-score-weighted comparison of radiation-related toxicity. Int. J. Cancer. 2021;149:149–157. doi: 10.1002/ijc.33525.
    1. Huang Y., Sanz J., Rodriguez N., Foro P., Reig A., Membrive I., Zhao M., Li X., Martinez A., Algara M. Effects of radiation on toxicity, complications, revision surgery and aesthetic outcomes in breast reconstruction: An argument about timing and techniques. J. Plast Reconstr. Aesthet. Surg. 2021;74:3316–3323. doi: 10.1016/j.bjps.2021.05.027.
    1. Ma S.J., Oladeru O.T., Singh A.K. Association of Endocrine Therapy With Overall Survival in Women With Small, Hormone Receptor-Positive, ERBB2-Negative Breast Cancer. JAMA Netw. Open. 2020;3:e2013973. doi: 10.1001/jamanetworkopen.2020.13973.
    1. Bober S.L., Fine E., Recklitis C.J. Sexual health and rehabilitation after ovarian suppression treatment (SHARE-OS): A clinical intervention for young breast cancer survivors. J. Cancer Surviv. 2020;14:26–30. doi: 10.1007/s11764-019-00800-x.
    1. Partridge A.H. Cancer survivorship and the young breast cancer patient: Addressing the important issues. Oncologist. 2013;18:e19–e20. doi: 10.1634/theoncologist.2013-0300.
    1. McIntosh J.G., Minshall J., Saya S., Bickerstaffe A., Hewabandu N., Qama A., Emery J.D. Benefits and harms of selective oestrogen receptor modulators (SERMs) to reduce breast cancer risk: A cross-sectional study of methods to communicate risk in primary care. Br. J. Gen. Pract. 2019;69:e836–e842. doi: 10.3399/bjgp19X706841.
    1. Sini V., Botticelli A., Lunardi G., Gori S., Marchetti P. Pharmacogenetics and aromatase inhibitor induced side effects in breast cancer patients. Pharmacogenomics. 2017;18:821–830. doi: 10.2217/pgs-2017-0006.
    1. Baumgart J., Nilsson K., Evers A.S., Kallak T.K., Poromaa I.S. Sexual dysfunction in women on adjuvant endocrine therapy after breast cancer. Menopause. 2013;20:162–168. doi: 10.1097/GME.0b013e31826560da.
    1. Robinson P.J., Bell R.J., Christakis M.K., Ivezic S.R., Davis S.R. Aromatase Inhibitors Are Associated With Low Sexual Desire Causing Distress and Fecal Incontinence in Women: An Observational Study. J. Sex Med. 2017;14:1566–1574. doi: 10.1016/j.jsxm.2017.09.018.
    1. Cortes J., Rugo H.S., Cescon D.W., Im S.A., Yusof M.M., Gallardo C., Lipatov O., Barrios C.H., Perez-Garcia J., Iwata H., et al. Pembrolizumab plus Chemotherapy in Advanced Triple-Negative Breast Cancer. N. Engl. J. Med. 2022;387:217–226. doi: 10.1056/NEJMoa2202809.
    1. Reese J.B., Beach M.C., Smith K.C., Bantug E.T., Casale K.E., Porter L.S., Bober S.L., Tulsky J.A., Daly M.B., Lepore S.J. Effective patient-provider communication about sexual concerns in breast cancer: A qualitative study. Support. Care Cancer. 2017;25:3199–3207. doi: 10.1007/s00520-017-3729-1.
    1. Flynn K.E., Lin L., Cyranowski J.M., Reeve B.B., Reese J.B., Jeffery D.D., Smith A.W., Porter L.S., Dombeck C.B., Bruner D.W., et al. Development of the NIH PROMIS (R) Sexual Function and Satisfaction measures in patients with cancer. J. Sex Med. 2013;10((Suppl. 1)):43–52. doi: 10.1111/j.1743-6109.2012.02995.x.
    1. Marwick C. Survey says patients expect little physician help on sex. JAMA. 1999;281:2173–2174. doi: 10.1001/jama.281.23.2173.
    1. Krouwel E.M., Albers L.F., Nicolai M.P.J., Putter H., Osanto S., Pelger R.C.M., Elzevier H.W. Discussing Sexual Health in the Medical Oncologist’s Practice: Exploring Current Practice and Challenges. J. Cancer Educ. 2020;35:1072–1088. doi: 10.1007/s13187-019-01559-6.
    1. Brotto L., Atallah S., Johnson-Agbakwu C., Rosenbaum T., Abdo C., Byers E.S., Graham C., Nobre P., Wylie K. Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction. J. Sex Med. 2016;13:538–571. doi: 10.1016/j.jsxm.2016.01.019.
    1. Runowicz C.D., Leach C.R., Henry N.L., Henry K.S., Mackey H.T., Cowens-Alvarado R.L., Cannady R.S., Pratt-Chapman M.L., Edge S.B., Jacobs L.A., et al. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. J. Clin. Oncol. 2016;34:611–635. doi: 10.1200/JCO.2015.64.3809.
    1. Gradishar W.J., Anderson B.O., Balassanian R., Blair S.L., Burstein H.J., Cyr A., Elias A.D., Farrar W.B., Forero A., Giordano S.H., et al. NCCN Guidelines Insights Breast Cancer, Version 1.2016. J. Natl. Compr. Canc. Netw. 2015;13:1475–1485. doi: 10.6004/jnccn.2015.0176.
    1. Bober S.L., Reese J.B., Barbera L., Bradford A., Carpenter K.M., Goldfarb S., Carter J. How to ask and what to do: A guide for clinical inquiry and intervention regarding female sexual health after cancer. Curr. Opin. Support. Palliat. Care. 2016;10:44–54. doi: 10.1097/SPC.0000000000000186.
    1. Bober S.L., Michaud A.L., Recklitis C.J. Finding sexual health aids after cancer: Are cancer centers supporting survivors’ needs? J. Cancer Surviv. 2019;13:224–230. doi: 10.1007/s11764-019-00744-2.
    1. Esposito K., Ciotola M., Marfella R., Di Tommaso D., Cobellis L., Giugliano D. The metabolic syndrome: A cause of sexual dysfunction in women. Int. J. Impot. Res. 2005;17:224–226. doi: 10.1038/sj.ijir.3901310.
    1. Salonia A., Lanzi R., Scavini M., Pontillo M., Gatti E., Petrella G., Licata G., Nappi R.E., Bosi E., Briganti A., et al. Sexual function and endocrine profile in fertile women with type 1 diabetes. Diabetes Care. 2006;29:312–316. doi: 10.2337/diacare.29.02.06.dc05-1067.
    1. Doumas M., Tsiodras S., Tsakiris A., Douma S., Chounta A., Papadopoulos A., Kanellakopoulou K., Giamarellou H. Female sexual dysfunction in essential hypertension: A common problem being uncovered. J. Hypertens. 2006;24:2387–2392. doi: 10.1097/01.hjh.0000251898.40002.5b.
    1. Esposito K., Ciotola M., Marfella R., Di Tommaso D., Cobellis L., Giugliano D. Sexual dysfunction in women with the metabolic syndrome. Diabetes Care. 2005;28:756. doi: 10.2337/diacare.28.3.756.
    1. Montagnese C., Porciello G., Vitale S., Palumbo E., Crispo A., Grimaldi M., Calabrese I., Pica R., Prete M., Falzone L., et al. Quality of Life in Women Diagnosed with Breast Cancer after a 12-Month Treatment of Lifestyle Modifications. Nutrients. 2020;13:136. doi: 10.3390/nu13010136.
    1. McCool-Myers M., Theurich M., Zuelke A., Knuettel H., Apfelbacher C. Predictors of female sexual dysfunction: A systematic review and qualitative analysis through gender inequality paradigms. BMC Womens Health. 2018;18:108. doi: 10.1186/s12905-018-0602-4.
    1. Inoue-Choi M., Lazovich D., Prizment A.E., Robien K. Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention is associated with better health-related quality of life among elderly female cancer survivors. J. Clin. Oncol. 2013;31:1758–1766. doi: 10.1200/JCO.2012.45.4462.
    1. De Cicco P., Catani M.V., Gasperi V., Sibilano M., Quaglietta M., Savini I. Nutrition and Breast Cancer: A Literature Review on Prevention, Treatment and Recurrence. Nutrients. 2019;11:1514. doi: 10.3390/nu11071514.
    1. Blanchard C.M., Courneya K.S., Stein K., American Cancer Society’s, Study of Cancer Survivors, II Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: Results from the American Cancer Society’s SCS-II. J. Clin. Oncol. 2008;26:2198–2204. doi: 10.1200/JCO.2007.14.6217.
    1. Anderson D.J., Seib C., McCarthy A.L., Yates P., Porter-Steele J., McGuire A., Young L. Facilitating lifestyle changes to manage menopausal symptoms in women with breast cancer: A randomized controlled pilot trial of The Pink Women’s Wellness Program. Menopause. 2015;22:937–945. doi: 10.1097/GME.0000000000000421.
    1. Kudesia R., Alexander M., Gulati M., Kennard A., Tollefson M. Dietary Approaches to Women’s Sexual and Reproductive Health. Am. J. Lifestyle Med. 2021;15:414–424. doi: 10.1177/15598276211007113.
    1. Esposito K., Ciotola M., Giugliano F., Schisano B., Autorino R., Iuliano S., Vietri M.T., Cioffi M., De Sio M., Giugliano D. Mediterranean diet improves sexual function in women with the metabolic syndrome. Int. J. Impot. Res. 2007;19:486–491. doi: 10.1038/sj.ijir.3901555.
    1. Vance V., Mourtzakis M., McCargar L., Hanning R. Weight gain in breast cancer survivors: Prevalence, pattern and health consequences. Obes. Rev. 2011;12:282–294. doi: 10.1111/j.1467-789X.2010.00805.x.
    1. Saquib N., Flatt S.W., Natarajan L., Thomson C.A., Bardwell W.A., Caan B., Rock C.L., Pierce J.P. Weight gain and recovery of pre-cancer weight after breast cancer treatments: Evidence from the women’s healthy eating and living (WHEL) study. Breast Cancer Res. Treat. 2007;105:177–186. doi: 10.1007/s10549-006-9442-2.
    1. World Cancer Research Fund. American Institute of Cancer Research The Continuous Update Project Expert Report 2018: Diet, Nutrition, Physical Activity and Breast Cancer. [(accessed on 30 June 2018)]. Available online: .
    1. Barnard N.D., Kahleova H., Holtz D.N., Del Aguila F., Neola M., Crosby L.M., Holubkov R. The Women’s Study for the Alleviation of Vasomotor Symptoms (WAVS): A randomized, controlled trial of a plant-based diet and whole soybeans for postmenopausal women. Menopause. 2021;28:1150–1156. doi: 10.1097/GME.0000000000001812.
    1. Roine E., Sintonen H., Kellokumpu-Lehtinen P.L., Penttinen H., Utriainen M., Vehmanen L., Huovinen R., Kautiainen H., Nikander R., Blomqvist C., et al. Health-related Quality of Life of Breast Cancer Survivors Attending an Exercise Intervention Study: A Five-year Follow-up. In Vivo. 2020;34:667–674. doi: 10.21873/invivo.11821.
    1. Cabral P.U., Canario A.C., Spyrides M.H., Uchoa S.A., Eleuterio Junior J., Giraldo P.C., Goncalves A.K. Physical activity and sexual function in middle-aged women. Rev. Assoc. Med. Bras. 2014;60:47–52. doi: 10.1590/1806-9282.60.01.011.
    1. Erol A., Karpyak V.M. Sex and gender-related differences in alcohol use and its consequences: Contemporary knowledge and future research considerations. Drug Alcohol Depend. 2015;156:1–13. doi: 10.1016/j.drugalcdep.2015.08.023.
    1. Seiler A., Jenewein J. Resilience in Cancer Patients. Front. Psychiatry. 2019;10:208. doi: 10.3389/fpsyt.2019.00208.
    1. Faubion S.S., Larkin L.C., Stuenkel C.A., Bachmann G.A., Chism L.A., Kagan R., Kaunitz A.M., Krychman M.L., Parish S.J., Partridge A.H., et al. Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer: Consensus recommendations from The North American Menopause Society and The International Society for the Study of Women’s Sexual Health. Menopause. 2018;25:596–608. doi: 10.1097/GME.0000000000001121.
    1. Schroder M., Mell L.K., Hurteau J.A., Collins Y.C., Rotmensch J., Waggoner S.E., Yamada S.D., Small W., Jr., Mundt A.J. Clitoral therapy device for treatment of sexual dysfunction in irradiated cervical cancer patients. Int. J. Radiat. Oncol. Biol. Phys. 2005;61:1078–1086. doi: 10.1016/j.ijrobp.2004.07.728.
    1. Pagano T., De Rosa P., Vallone R., Schettini F., Arpino G., Giuliano M., Lauria R., De Santo I., Conforti A., Gallo A., et al. Fractional microablative CO2 laser in breast cancer survivors affected by iatrogenic vulvovaginal atrophy after failure of nonestrogenic local treatments: A retrospective study. Menopause. 2018;25:657–662. doi: 10.1097/GME.0000000000001053.
    1. Gittens P., Mullen G. The effects of fractional microablative CO2 laser therapy on sexual function in postmenopausal women and women with a history of breast cancer treated with endocrine therapy. J. Cosmet. Laser Ther. 2019;21:127–131. doi: 10.1080/14764172.2018.1481510.
    1. Li F.G., Maheux-Lacroix S., Deans R., Nesbitt-Hawes E., Budden A., Nguyen K., Lim C.Y., Song S., McCormack L., Lyons S.D., et al. Effect of Fractional Carbon Dioxide Laser vs. Sham Treatment on Symptom Severity in Women With Postmenopausal Vaginal Symptoms: A Randomized Clinical Trial. JAMA. 2021;326:1381–1389. doi: 10.1001/jama.2021.14892.
    1. Wills S., Ravipati A., Venuturumilli P., Kresge C., Folkerd E., Dowsett M., Hayes D.F., Decker D.A. Effects of vaginal estrogens on serum estradiol levels in postmenopausal breast cancer survivors and women at risk of breast cancer taking an aromatase inhibitor or a selective estrogen receptor modulator. J. Oncol. Pract. 2012;8:144–148. doi: 10.1200/JOP.2011.000352.
    1. Biglia N., Peano E., Sgandurra P., Moggio G., Panuccio E., Migliardi M., Ravarino N., Ponzone R., Sismondi P. Low-dose vaginal estrogens or vaginal moisturizer in breast cancer survivors with urogenital atrophy: A preliminary study. Gynecol. Endocrinol. 2010;26:404–412. doi: 10.3109/09513591003632258.
    1. Barton D.L., Sloan J.A., Shuster L.T., Gill P., Griffin P., Flynn K., Terstriep S.A., Rana F.N., Dockter T., Atherton P.J., et al. Evaluating the efficacy of vaginal dehydroepiandosterone for vaginal symptoms in postmenopausal cancer survivors: NCCTG N10C1 (Alliance) Support. Care Cancer. 2018;26:643–650. doi: 10.1007/s00520-017-3878-2.
    1. Goetsch M.F., Lim J.Y., Caughey A.B. A Practical Solution for Dyspareunia in Breast Cancer Survivors: A Randomized Controlled Trial. J. Clin. Oncol. 2015;33:3394–3400. doi: 10.1200/JCO.2014.60.7366.
    1. Chen J., Geng L., Song X., Li H., Giordan N., Liao Q. Evaluation of the efficacy and safety of hyaluronic acid vaginal gel to ease vaginal dryness: A multicenter, randomized, controlled, open-label, parallel-group, clinical trial. J. Sex Med. 2013;10:1575–1584. doi: 10.1111/jsm.12125.
    1. Simon J.A., Clayton A.H., Kim N.N., Patel S. Clinically Meaningful Benefit in Women with Hypoactive Sexual Desire Disorder Treated with Flibanserin. Sex. Med. 2022 doi: 10.1016/j.esxm.2021.100476.
    1. Portman D.J., Brown L., Yuan J., Kissling R., Kingsberg S.A. Flibanserin in Postmenopausal Women With Hypoactive Sexual Desire Disorder: Results of the PLUMERIA Study. J. Sex Med. 2017;14:834–842. doi: 10.1016/j.jsxm.2017.03.258.
    1. Clayton A.H., Brown L., Kim N.N. Evaluation of safety for flibanserin. Expert Opin Drug Saf. 2020;19:1–8. doi: 10.1080/14740338.2020.1707804.
    1. Simon J.A., Derogatis L., Portman D., Brown L., Yuan J., Kissling R. Flibanserin for Hypoactive Sexual Desire Disorder: An Open-Label Safety Study. J. Sex Med. 2018;15:387–395. doi: 10.1016/j.jsxm.2017.12.016.
    1. Simon J.A., Kingsberg S.A., Portman D., Williams L.A., Krop J., Jordan R., Lucas J., Clayton A.H. Long-Term Safety and Efficacy of Bremelanotide for Hypoactive Sexual Desire Disorder. Obstet Gynecol. 2019;134:909–917. doi: 10.1097/AOG.0000000000003514.
    1. Seav S.M., Dominick S.A., Stepanyuk B., Gorman J.R., Chingos D.T., Ehren J.L., Krychman M.L., Su H.I. Management of sexual dysfunction in breast cancer survivors: A systematic review. Womens Midlife Health. 2015;1:9. doi: 10.1186/s40695-015-0009-4.
    1. Puppo G., Puppo V.U.S. Food and Drug Administration Approval of Addyi (Flibanserin) for Treatment of Hypoactive Sexual Desire Disorder. Eur. Urol. 2016;69:379–380. doi: 10.1016/j.eururo.2015.09.050.
    1. Goldfarb S., Carter J., Arkema A., Abdo N., Carpio A., Chang C., Vahdat L. Flibanserin Improves Libido In Women with Breast Cancer. J. Sex Med. 2022;19:S9–S10. doi: 10.1016/j.jsxm.2022.05.024.
    1. Dhillon S., Keam S.J. Bremelanotide: First Approval. Drugs. 2019;79:1599–1606. doi: 10.1007/s40265-019-01187-w.
    1. Mayer D., Lynch S.E. Bremelanotide: New Drug Approved for Treating Hypoactive Sexual Desire Disorder. Ann. Pharm. 2020;54:684–690. doi: 10.1177/1060028019899152.
    1. Koochaki P., Revicki D., Wilson H., Pokrzywinski R., Jordan R., Lucas J., Williams L.A., Sadiq A., Krop J. The Patient Experience of Premenopausal Women Treated with Bremelanotide for Hypoactive Sexual Desire Disorder: RECONNECT Exit Study Results. J. Womens Health. 2021;30:587–595. doi: 10.1089/jwh.2020.8460.
    1. Nappi R.E., Tiranini L., Cucinella L., Martini E., Bosoni D., Righi A., Cassani C., Gardella B. Pharmacotherapy for female sexual dysfunctions (FSDs): What is on the market and where is this field heading? Expert Opin. Pharmacother. 2022 doi: 10.1080/14656566.2022.2066997.
    1. Edinoff A.N., Sanders N.M., Lewis K.B., Apgar T.L., Cornett E.M., Kaye A.M., Kaye A.D. Bremelanotide for Treatment of Female Hypoactive Sexual Desire. Neurol. Int. 2022;14:75–88. doi: 10.3390/neurolint14010006.
    1. Kingsberg S.A., Clayton A.H., Portman D., Williams L.A., Krop J., Jordan R., Lucas J., Simon J.A. Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder: Two Randomized Phase 3 Trials. Obstet. Gynecol. 2019;134:899–908. doi: 10.1097/AOG.0000000000003500.
    1. Stahl S.M., Pradko J.F., Haight B.R., Modell J.G., Rockett C.B., Learned-Coughlin S. A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor. Prim. Care Companion J. Clin. Psychiatry. 2004;6:159–166. doi: 10.4088/PCC.v06n0403.
    1. Bodenmann P. Questions lors de l’enseignement clinique: Vive Socrate! Rev. Med. Suisse. 2016;12:1828.
    1. Hoffman B.M., Zevon M.A., D’Arrigo M.C., Cecchini T.B. Screening for distress in cancer patients: The NCCN rapid-screening measure. Psychooncology. 2004;13:792–799. doi: 10.1002/pon.796.
    1. Carreira H., Williams R., Muller M., Harewood R., Stanway S., Bhaskaran K. Associations Between Breast Cancer Survivorship and Adverse Mental Health Outcomes: A Systematic Review. J. Natl. Cancer Inst. 2018;110:1311–1327. doi: 10.1093/jnci/djy177.
    1. Hummel S.B., Hahn D.E.E., van Lankveld J., Oldenburg H.S.A., Broomans E., Aaronson N.K. Factors Associated With Specific Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Sexual Dysfunctions in Breast Cancer Survivors: A Study of Patients and Their Partners. J. Sex Med. 2017;14:1248–1259. doi: 10.1016/j.jsxm.2017.08.004.
    1. Hummel S.B., van Lankveld J., Oldenburg H.S.A., Hahn D.E.E., Kieffer J.M., Gerritsma M.A., Kuenen M.A., Bijker N., Borgstein P.J., Heuff G., et al. Internet-Based Cognitive Behavioral Therapy Realizes Long-Term Improvement in the Sexual Functioning and Body Image of Breast Cancer Survivors. J. Sex Marital Ther. 2018;44:485–496. doi: 10.1080/0092623X.2017.1408047.
    1. Riley A. The role of the partner in erectile dysfunction and its treatment. Int J. Impot. Res. 2002;14((Suppl 1)):S105–S109. doi: 10.1038/sj.ijir.3900800.
    1. Kowalczyk R., Nowosielski K., Cedrych I., Krzystanek M., Glogowska I., Streb J., Kucharz J., Lew-Starowicz Z. Factors Affecting Sexual Function and Body Image of Early-Stage Breast Cancer Survivors in Poland: A Short-Term Observation. Clin. Breast Cancer. 2019;19:e30–e39. doi: 10.1016/j.clbc.2018.09.006.
    1. Borstelmann N.A., Rosenberg S., Gelber S., Zheng Y., Meyer M., Ruddy K.J., Schapira L., Come S., Borges V., Cadet T., et al. Partners of young breast cancer survivors: A cross-sectional evaluation of psychosocial concerns, coping, and mental health. J. Psychosoc. Oncol. 2020;38:670–686. doi: 10.1080/07347332.2020.1823546.
    1. Velten J., Margraf J. Satisfaction guaranteed? How individual, partner, and relationship factors impact sexual satisfaction within partnerships. PLoS ONE. 2017;12:e0172855. doi: 10.1371/journal.pone.0172855.
    1. Velten J., Margraf J., Chivers M.L., Brotto L.A. Effects of a Mindfulness Task on Women’s Sexual Response. J. Sex Res. 2018;55:747–757. doi: 10.1080/00224499.2017.1408768.
    1. Velten J., Scholten S., Graham C.A., Margraf J. Sexual Excitation and Sexual Inhibition as Predictors of Sexual Function in Women: A Cross-Sectional and Longitudinal Study. J. Sex Marital Ther. 2017;43:95–109. doi: 10.1080/0092623X.2015.1115792.
    1. Rehman U.S., Rellini A.H., Fallis E. The importance of sexual self-disclosure to sexual satisfaction and functioning in committed relationships. J. Sex Med. 2011;8:3108–3115. doi: 10.1111/j.1743-6109.2011.02439.x.
    1. Sebri V., Durosini I., Triberti S., Pravettoni G. The Efficacy of Psychological Intervention on Body Image in Breast Cancer Patients and Survivors: A Systematic-Review and Meta-Analysis. Front. Psychol. 2021;12:611954. doi: 10.3389/fpsyg.2021.611954.
    1. Kwait R.M., Pesek S., Onstad M., Edmonson D., Clark M.A., Raker C., Stuckey A., Gass J. Influential Forces in Breast Cancer Surgical Decision Making and the Impact on Body Image and Sexual Function. Ann. Surg. Oncol. 2016;23:3403–3411. doi: 10.1245/s10434-016-5365-2.
    1. Boquiren V.M., Esplen M.J., Wong J., Toner B., Warner E., Malik N. Sexual functioning in breast cancer survivors experiencing body image disturbance. Psychooncology. 2016;25:66–76. doi: 10.1002/pon.3819.
    1. Parton C.M., Ussher J.M., Perz J. Women’s Construction of Embodiment and the Abject Sexual Body After Cancer. Qual. Health Res. 2016;26:490–503. doi: 10.1177/1049732315570130.
    1. Dahlback C., Manjer J., Rehn M., Ringberg A. Determinants for patient satisfaction regarding aesthetic outcome and skin sensitivity after breast-conserving surgery. World J. Surg. Oncol. 2016;14:303. doi: 10.1186/s12957-016-1053-8.
    1. Ashing-Giwa K.T., Padilla G., Tejero J., Kraemer J., Wright K., Coscarelli A., Clayton S., Williams I., Hills D. Understanding the breast cancer experience of women: A qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psychooncology. 2004;13:408–428. doi: 10.1002/pon.750.
    1. Fobair P., Stewart S.L., Chang S., D’Onofrio C., Banks P.J., Bloom J.R. Body image and sexual problems in young women with breast cancer. Psychooncology. 2006;15:579–594. doi: 10.1002/pon.991.
    1. Paterson C.L., Lengacher C.A., Donovan K.A., Kip K.E., Tofthagen C.S. Body Image in Younger Breast Cancer Survivors: A Systematic Review. Cancer Nurs. 2016;39:E39–E58. doi: 10.1097/NCC.0000000000000251.
    1. Trachtenberg L., Wong J., Rennie H., McLeod D., Leung Y., Warner E., Esplen M.J. Feasibility and acceptability of i-Restoring Body Image after Cancer (i-ReBIC): A pilot trial for female cancer survivors. Psychooncology. 2020;29:639–646. doi: 10.1002/pon.5288.
    1. Reese J.B., Sorice K., Beach M.C., Porter L.S., Tulsky J.A., Daly M.B., Lepore S.J. Patient-provider communication about sexual concerns in cancer: A systematic review. J. Cancer Surviv. 2017;11:175–188. doi: 10.1007/s11764-016-0577-9.
    1. Park E.R., Norris R.L., Bober S.L. Sexual health communication during cancer care: Barriers and recommendations. Cancer J. 2009;15:74–77. doi: 10.1097/PPO.0b013e31819587dc.
    1. Sopfe J., Pettigrew J., Afghahi A., Appiah L.C., Coons H.L. Interventions to Improve Sexual Health in Women Living with and Surviving Cancer: Review and Recommendations. Cancers. 2021;13:3153. doi: 10.3390/cancers13133153.
    1. APTA Pelvic Health Activating Your Pelvic Floor Muscles Using Kegels and Physical Therapy. [(accessed on 30 June 2015)]. Available online:
    1. Berghmans B. The role of the pelvic physical therapist. Actas Urol. Esp. 2006;30:110–122. doi: 10.1016/S0210-4806(06)73412-X. El papel del fisioterapeuta pelvico.
    1. Frawley H., Shelly B., Morin M., Bernard S., Bo K., Digesu G.A., Dickinson T., Goonewardene S., McClurg D., Rahnama’i M.S., et al. An International Continence Society (ICS) report on the terminology for pelvic floor muscle assessment. Neurourol. Urodyn. 2021;40:1217–1260. doi: 10.1002/nau.24658.
    1. Vandyken C., Hilton S. Physical Therapy in the Treatment of Central Pain Mechanisms for Female Sexual Pain. Sex Med. Rev. 2017;5:20–30. doi: 10.1016/j.sxmr.2016.06.004.
    1. Cyr M.P., Dumoulin C., Bessette P., Pina A., Gotlieb W.H., Lapointe-Milot K., Mayrand M.H., Morin M. Feasibility, acceptability and effects of multimodal pelvic floor physical therapy for gynecological cancer survivors suffering from painful sexual intercourse: A multicenter prospective interventional study. Gynecol. Oncol. 2020;159:778–784. doi: 10.1016/j.ygyno.2020.09.001.
    1. Cyr M.P., Dostie R., Camden C., Dumoulin C., Bessette P., Pina A., Gotlieb W.H., Lapointe-Milot K., Mayrand M.H., Morin M. Improvements following multimodal pelvic floor physical therapy in gynecological cancer survivors suffering from pain during sexual intercourse: Results from a one-year follow-up mixed-method study. PLoS ONE. 2022;17:e0262844. doi: 10.1371/journal.pone.0262844.
    1. Boswell E.N., Dizon D.S. Breast cancer and sexual function. Transl. Androl. Urol. 2015;4:160–168. doi: 10.3978/j.issn.2223-4683.2014.12.04.
    1. Ghaderi F., Bastani P., Hajebrahimi S., Jafarabadi M.A., Berghmans B. Pelvic floor rehabilitation in the treatment of women with dyspareunia: A randomized controlled clinical trial. Int. Urogynecol. J. 2019;30:1849–1855. doi: 10.1007/s00192-019-04019-3.
    1. Advani P., Brewster A.M., Baum G.P., Schover L.R. A pilot randomized trial to prevent sexual dysfunction in postmenopausal breast cancer survivors starting adjuvant aromatase inhibitor therapy. J. Cancer Surviv. 2017;11:477–485. doi: 10.1007/s11764-017-0606-3.
    1. Mercier J., Morin M., Tang A., Reichetzer B., Lemieux M.C., Samir K., Zaki D., Gougeon F., Dumoulin C. Pelvic floor muscle training: Mechanisms of action for the improvement of genitourinary syndrome of menopause. Climacteric. 2020;23:468–473. doi: 10.1080/13697137.2020.1724942.
    1. Trahan J., Leger E., Allen M., Koebele R., Yoffe M.B., Simon C., Alappattu M., Figuers C. The Efficacy of Manual Therapy for Treatment of Dyspareunia in Females: A Systematic Review. J. Womens Health Phys. Therap. 2019;43:28–35. doi: 10.1097/JWH.0000000000000117.
    1. Faubion S.S., Sood R., Kapoor E. Genitourinary Syndrome of Menopause: Management Strategies for the Clinician. Mayo Clin. Proc. 2017;92:1842–1849. doi: 10.1016/j.mayocp.2017.08.019.
    1. Liu M., Juravic M., Mazza G., Krychman M.L. Vaginal Dilators: Issues and Answers. Sex Med. Rev. 2021;9:212–220. doi: 10.1016/j.sxmr.2019.11.005.
    1. Law E., Kelvin J.F., Thom B., Riedel E., Tom A., Carter J., Alektiar K.M., Goodman K.A. Prospective study of vaginal dilator use adherence and efficacy following radiotherapy. Radiother. Oncol. 2015;116:149–155. doi: 10.1016/j.radonc.2015.06.018.
    1. Alperstein D., Sharpe L. The Efficacy of Motivational Interviewing in Adults With Chronic Pain: A Meta-Analysis and Systematic Review. J. Pain. 2016;17:393–403. doi: 10.1016/j.jpain.2015.10.021.
    1. Quinn G.P., Sanchez J.A., Sutton S.K., Vadaparampil S.T., Nguyen G.T., Green B.L., Kanetsky P.A., Schabath M.B. Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. CA Cancer J. Clin. 2015;65:384–400. doi: 10.3322/caac.21288.
    1. Kamen C., Palesh O., Gerry A.A., Andrykowski M.A., Heckler C., Mohile S., Morrow G.R., Bowen D., Mustian K. Disparities in Health Risk Behavior and Psychological Distress Among Gay Versus Heterosexual Male Cancer Survivors. LGBT Health. 2014;1:86–92. doi: 10.1089/lgbt.2013.0022.
    1. Seay J., Mitteldorf D., Yankie A., Pirl W.F., Kobetz E., Schlumbrecht M. Survivorship care needs among LGBT cancer survivors. J. Psychosoc. Oncol. 2018;36:393–405. doi: 10.1080/07347332.2018.1447528.
    1. Goldhammer H., Maston E.D., Kissock L.A., Davis J.A., Keuroghlian A.S. National Findings from an LGBT Healthcare Organizational Needs Assessment. LGBT Health. 2018;5:461–468. doi: 10.1089/lgbt.2018.0118.
    1. Moore L.J. Understanding the role of National Public Health Surveys in identifying health care disparities affecting LGBT people. J. Homosex. 2013;60:1251–1255. doi: 10.1080/00918369.2013.806164.

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