Study Of Cervical Cancer Survivors Suggests Hormones' Role In Sexuality Is Limited

Main Category: Cervical Cancer / HPV Vaccine
Article Date: 09 Sep 2008 - 0:00 PDT

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Most long-term cervical cancer survivors report they have satisfying sex lives following surgical intervention, according to a recent study that challenges public perceptions of the role hormones play in sexual activity.

The University of Southern California-Yale University study is significant because researchers documented the sexual experiences of women who presumably had no hormonally-motivated sexual behavior or interest. Surgical intervention for cervical cancer often involves removing the ovaries, which reduces or eliminates circulating testosterone. The hormone is a factor in both male and female sexual behavior .

"Our findings, which demonstrate the existence of widespread interest and satisfaction with sex in the absence of a crucial hormone underscore the importance of non-hormonal components of sexual interest and satisfaction," said lead author Howard Greenwald, a USC professor with the School of Policy, Planning, and Development. "That may mean the key to sexual satisfaction is less about biology and more about psychology."

The study, "Sexuality and Sexual Function in Long-Term Survivors of Cervical Cancer," appears in the recent issue of Journal of Women's Health. It was co-authored with Ruth McCorkle of Yale University's School of Nursing.

During the first months and years following treatment for cervical cancer, women often struggle with what they perceive to be assault on their sexual organs and identity, Greenwald said. Most studies of cancer survivors follow patients no more than five years after diagnosis and treatment but the researchers found that after six years most women's sexual desire and enjoyment rebounds. In this particular study, the researchers interviewed women six to 28 years from their initial diagnosis.

Based on interviews with 179 women, the researchers found that:

-- Over 80 percent of the cervical cancer survivors reported being sexually active.

-- 81.4 percent said they "sometimes," "almost always" or "always" desired sexual activity.

-- 90.9 percent indicated they enjoyed sexual activity at least some of the time.

When asked if cervical cancer had a negative effect on their relationships, one-third of the women agreed. Conversely, two-thirds disagreed with that statement.

"This observation is important because the public places so much emphasis on 'hormones' in sex and the pharmaceutical industry is poised to release a whole new generation of hormone-based drugs for female sexuality," said Greenwald. "A person's outlook, relationships and other factors may be just as important, or even more important."

The disease was expected to be diagnosed in as many as 11,150 women in 2007, according to the American Cancer Society. Most women are diagnosed at an early stage and can expect to have a normal or near-normal life expectancy, which is why issues of sexual desire and enjoyment are significant for this population.

Typically, doctors perform hysterectomies surgical removal of the uterus - or oophorectomies removal of one or both ovaries - to treat invasive cervical cancer.

The researchers found a difference in sexual interest between these two groups.

Women with hysterectomies were less likely to report a lack of interest in sex compared to the other women. On the other hand, women who had oophorectomies were less likely to report they enjoyed sex compared to the other women. Oophorectomies typically affect circulating sexual hormones and results in reduced vaginal lubrication.

"The women who've lost their ovaries, and thus the naturally circulating testosterone, are less likely to enjoy sex," said Greenwald. "However, women who've had this ovary-removing procedure are statistically no less likely to be sexually active or more likely to lack sexual desire than women who still have their ovaries."

The women contacted for the study were diagnosed with primary invasive cervical cancer between 1974 and 1996. The mean age of the subjects at the time of the study was 51.7 years and the mean age at the time of diagnosis was 37.9 years.

Co-author Ruth McCorkle said that as people live longer with cancer due to early detection and advances in treatment there is a greater need for studies such as this one to include long-term survivors of cancer.

"These results underscore how important it is to include people who are long-term survivors and to assess their quality of life in terms of their sexuality, their relationships with others, and their ability to be productive members of our society."

University of Southern California
3375 S Hoover St.
Los Angeles, CA 90089
United States
http://www.usc.edu

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