Vaginal changes and sexuality in women with a history of cervical cancer

Background In women with cervical cancer, treatment causes changes in vagin al anatomy and function. The effect of these changes on sexual function and the extent, if any, to which they distress women are not known. Methods In 1996 and 1997, we attempted to contact 332 women with a history of early-stage cervical cancer (age range, 26 to 80 years) who had been tre ated in 1991 and 1992 at the seven departments of gynecological oncology in Sweden and 489 women without a history of cancer (controls) to ask them to answer an anonymous questionnaire about vaginal changes and sexual functio n. Results We received completed questionnaires from 256 of the women with a h istory of cervical cancer and 350 of the controls. A total of 167 of 247 wo men with a history of cancer (68 percent) and 236 of 330 controls (72 perce nt) reported that they had regular vaginal intercourse. Twenty-six percent of the women who had cancer and 11 percent of the controls reported insuffi cient vaginal lubrication for sexual intercourse, 26 percent of the women w ho had cancer and 3 percent of the controls reported a short vagina, and 23 percent of the women who had cancer and 4 percent of the controls reported an insufficiently elastic vagina. Twenty-six percent of the women who had cancer reported moderate or much distress due to vaginal changes, as compar ed with 8 percent of the women in the control group. Dyspareunia was also m ore common among the women who had cervical cancer. The frequency of orgasm s and orgasmic pleasure was similar in the two groups. Among the women who had cervical cancer, the type of treatment received had little if any effec t on the prevalence of specific vaginal changes. Conclusions Women who have been treated for cervical cancer have persistent vaginal changes that compromise sexual activity and result in considerable distress. (N Engl J Med 1999;340:1383-9.) (C) 1999, Massachusetts Medical Society.