Female sexual life during malignancies

The diagnosis of cancer is the first, critical moment, which causes in hearers feelings of incredulity, fear, and insecurity about their future. Its reverberations also affect the partner, if there is one, who in turn may suffer from preexisting sexual dysfunctions.As is logical, in the past studies on cancer and sexual dysfunction were at first focused on cancers directly or indirectly involving the sexual and reproductiveorgans. Later research has widened out to include sexual dysfunctions in oncological patients regardless of the seat of the original neoplasia. As can be imagined, gynecologic and breast cancers are those that most frequently have a negative impact on a woman’s sexual health. The surgical treatment undergone by these patients creates direct anatomical damage and distorts their body image, causing them to perceive their body as sexually unattractive. This in turn creates changes in the response to the stimuli that influence desire, with inadequate vaginal lubrication and genital swelling that in the end lead to less frequent sex, with the absence of well-being, pleasure and sexual satisfaction, and consequent inability to reach orgasm . A paradigmatic example is represented by premenopausal salpingooophorectomy, which leads to the physical and hormonal changes typical of early menopause, seen in the various domains that characterize female sexual dysfunctions as they are currently classified [22]. Besides the aftermaths ofsurgery, more and more frequently multimodal protocols also consider the consequences of chemo and/or radiotherapy, which can continue to have negative effects after many years. Cancers apparently “distant” from the parts of the bodyassociated with sexuality constitute a separate question. Examples are head and neck tumors, which by causing significant facial alterations (disfigurement),vocal changes (speech), and changes in breathing and salivation, can have a strong impact on self-esteem and therefore on interpersonal and couple relationships .But there is no doubt that there are many other neoplastic sites with a direct negative impact on the sexual lives of men and women, whether as a consequence ofprimary surgical treatment or of related pharmacologic, radiation, or biological treatments. Among these are colon/rectal tumors ], those of the head and neck[25] and of the bladder, lymphatic cancers , and lung cancers.