Contact Dr. Rojas to learn more about bringing the MUSIC Sexual Health After Cancer Program to your practice. Help improve your patients’survivorship by implementing evidence-based, patient-centered guidelines to address the complex, distressing issue of sexual dysfunction after cancer.

An Underrecognized Problem in Women’s Survivorship

By 2026, there will be more than 20.3 million cancer survivors living in the United States. With approximately one-half of those survivors being women, cancer care providers will need to focus on optimizing survivorship outcomes for female cancer survivors.

In survivorship, women encounter both the physical and psychosocial consequences of breast cancer treatment, which can have a profound negative impact on body image and sexual function. Beyond the partial or complete loss of one or both breasts, treatment can result in the physical challenges of alopecia, lymphedema, and significant weight gain, as well as sexual health implications of premature menopause and loss of fertility. Temporary or permanent, these changes alter a woman’s relationship with herself and can negatively impact a woman’s perception of her physical appearance, function, health, and sexuality.

Many women are embarrassed or ashamed to ask about sexual health issues after surviving cancer. If you survived cancer, you should feel lucky and not complain right? WRONG.​​

You are not alone. Your life has been changed by the diagnosis or the treatment. Abrupt hormone changes due to chemotherapy or hormonal therapy, surgery, or radiation may have caused sexual health or vaginal side effects. Premature menopause, lack of desire or difficulty with arousal, pain during intercourse, vaginal dryness or vulvar symptoms are very common during diagnosis, treatment, and survivorship.

Women at increased risk of cancer also affected. National guidelines recommend that BRCA mutation carriers undergo bilateral salpingo-oophorectomy (removing both fallopian tubes and ovaries) between age 35-45, which causes an immediate transition into menopause (often felt within 48 hours of surgery). Other women with significant family history without a BRCA mutation may also be affected when they are prescribed medication to prevent breast cancer such as tamoxifen or anastrazole.

It turns out that cancer care providers are not adequately screening female survivors for these issues, and patients might be afraid to ask. If you search “sexual dysfunction” in Google, you will find that the search engine thinks that sexual dysfunction is only a male problem.​​

In one study, 29% of breast cancer survivors reported that they received any information regarding sexual issues, while 80% of prostate cancer patients reported that they received this counseling. Women with cancer are probably disproportionately screened and treated for sexual dysfunction during and after treatment.

Challenges to Addressing Sexual Dysfunction

Cancer patients consistently report low satisfaction related to counseling regarding treatment and its side effects. More than half of breast cancer survivors report sexual dysfunction, and 77% of all women, 60% who were previously sexually active reported sexual dysfunction 7 years after treatment. Among the studied patients:

55% reported vaginal dryness
40% reported vaginal pain
51% reported loss of libido

The treatment of sexual dysfunction in cancer care is complex and requires coordination between care teams (and a lot of time).

The MUSIC Program

At MUSIC, we can help prepare you for the changes that you may experience before you receive treatment. The MUSIC Sexual Health After Cancer Program also helps patients during and after treatment. Sexual dysfunction issues that arise during treatment can include anatomical changes such as vaginal dryness, pelvic nerve damage from surgery or radiation, physical changes such as painful intercourse, premature ovarian failure (premature menopause), and psychosocial issues such as negative body image, decreased desire, and feelings of loss of femininity. Sometimes, patients may feel anxious or depressed about these issues. At MUSIC, your concerns will be validated and misconceptions will be clarified. Oftentimes, patients may believe that they are the only one experiencing these issues, but more than 60% of cancer survivors report some element of sexual dysfunction.

During and after your treatment, you may not be able to return to the same version of sexuality that was present pre-treatment. A lot will happen, but MUSIC can help you establish your new normal, cope with the side effects, and optimize your survivorship. Your physician might give you a survey like the Brief Sexual Symptoms Checklist shown below.

Sexual dysfunction during and after cancer treatment is extremely common, oftentimes not addressed, and complicated. Patients should feel empowered to bring up these issues to their cancer care providers, and as physicians who treat cancer, we should do a better job screening them. Just asking the question can improve patient care. In the Menopause, Urogenital, Sexual Health and Intimacy Program led by Dr. Kristin Rojas, we understand these concerns and are here to help.

The MUSIC Program is currently located at University of Miami – Sylvester Comprehensive Cancer Center.

To make an appointment please call (305)243-1000.