Sexuality after gynaecological cancer: a review of the material, intrapsychic, and discursive aspects of treatment on women's sexual-wellbeing.

Research in the area of gynaecological cancer has increasingly examined changes to women's sexuality, with the impact of treatment on sexual wellbeing considered particularly important. The objective of this paper is to review research on gynaecological cancer and sexuality from the years 1990 to 2011. Research has documented a range of post-treatment anatomical and physical changes to women's sexual wellbeing, including changes to sexual desire, pleasure, orgasm, vaginal lubrication, genital sensitivity, arousal, and frequency of sex. Women's intrapsychic experiences of changes to sexuality include anxiety, depression, distress, and negative perceptions of sexual identity and body image. Socially constructed discourses surrounding gender and sexuality also shape women's experiences of their sexual wellbeing post-gynaecological cancer and treatment, with many women feeling a loss of womanhood and femininity with the removal of, or changes to, their reproductive organs. Finally, women's relationship context, pattern of couple communication, and partner support are associated with women's ability to cope with changes to sexuality post-gynaecological cancer. Given that sexuality is an important part of quality of life, it is important that health professionals actively communicate information to women and their partner about the effects of treatment on sexual wellbeing, in order to legitimate and normalise sexuality in this context. It is concluded that research in the area of gynaecological cancer and sexuality needs to acknowledge not only the physical/anatomical/material effects of cancer treatments, but also women's intrapsychic experiences of changes to sexuality, her relationship context, and the role of gendered discourses in shaping women's experiences of sexuality post-gynaecological cancer and treatment.