RADIATION THERAPY for gynecologic cancers carries lasting adverse effects on sexual health, a new systematic review has found.¹

Patient-Reported Outcomes

Researchers analysed a total of 26 studies, comprising data from 5,646 patients.

In analysis, 11 studies focused on cervical cancer, seven on endometrial cancer, and eight on mixed gynecological malignancies.

Results were based on patient-reported outcomes, commonly through the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30, Quality of Life Questionnaire-CX24, Female Sexual Function Index, Late Effects on Normal Tissues – Subjective, Objective, Management, and Analytic framework, and Sex Adjustment Questionnaire.

Radiation Linked to Sexual Dysfunction

Radiation was consistently tied to long-term sexual dysfunction, including vaginal dryness, dyspareunia, and diminished sexual satisfaction.

Sexual activity tended to decrease after treatment.

However, it improved over time and eventually stabilised.

Improving Sexual Health Outcomes After Radiation Therapy

Regular vaginal dilation was associated with maintained vaginal length and enhanced sexual function.

However, it did not impact vaginal elasticity.

Psychological, Social, and Cultural Influences

Psychological, social, and cultural factors also influenced sexual health outcomes, researchers reported.

For example, women with more advanced-stage cervical cancer had poorer sexual adjustment scores,² and White women reported less sexual desire, more pain, and lower total FSFI scores than Black women.³

Notably, influences such as emotional intimacy, partner support, and mental health, were rarely explored in depth, despite being paramount to enabling sexual recovery.¹

Researchers called for standardised, culturally sensitive measures and multidisciplinary approaches in future studies, to holistically address the physical, psychological, and social parameters of sexual recovery in patients who have undergone radiation therapy for gynecologic cancer.

References

¹ Hathout L et al. A systematic review of patient-reported outcomes on the impact of radiation therapy on sexual health in patients with gynecologic cancer. Int J Radiat Oncol Biol Phys. 2026;125(2):426–443.

² Conway JL et al. Patient-reported sexual adjustment after definitive chemoradiation and MR-guided brachytherapy for cervical cancer. Brachytherapy.

³ Bai J et al. Comparisons of depression, sexual function, and quality of life between women with gynecological cancers and race-matched healthy controls. Cancer Nurs. 2021;44:116–124.

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