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Sexual Function and Cancer | Image Courtesy of Priscilla Du Preez via Unsplash
Sexual Function and Cancer | Image Courtesy of Priscilla Du Preez via Unsplash

Physical Therapy Can Mitigate the Effects of Cancer on Sexual Function

Sexuality can be a big part of who we are as individuals. Sexual function can be defined as “specific physical, physiological, neurological and emotional behaviors expressed by an individual response”.5 Sexual function and cancer can have an important and detrimental relationship.  There are certain cancers that can unfortunately affect our sexual health, including cervical, ovarian, bladder, kidney, colorectal and breast cancer to name a few.

Some cancer treatments can cause unwanted side effects that affect our sexual health such as decreased sexual arousal or desire, vaginal stenosis (narrowing of the vaginal canal), dyspareunia (painful sexual intercourse), and bladder/bowel dysfunction. This can affect our relationships with ourselves and with our partners, and reduce quality of life.

Hopefully a physical therapist is part of your team to help guide you during this challenging time and minimize these aforementioned side effects. Otherwise, ask for a pelvic floor physical therapist to join your team during your recovery! 

Sexual Function and Types of Cancer

Sixty-seven percent of those diagnosed with gynecological cancer suffer from dyspareunia. In other cancers that are not directly related to genitals can experience sexual dysfunction. In those diagnosed with breast cancer, 50-75% also have pain with sexual intercourse. Common symptoms after bladder or kidney cancer surgeries include decreased sexual desire, decreased ability to achieve orgasm, decreased lubrication, and dyspareunia. Some kidney surgeries bypass the abdominal surgical approach and attempt to remove kidney or tumor intravaginally, which is a less invasive approach. As you can see, the pelvic floor musculature is a very involved player in promoting healthy bladder and bowel function. More importantly, pelvic floor muscles are crucial in sexual function. 

Sexual Function and Cancer Treatments

Radiation, immunotherapies, chemotherapy, antihormonal therapies (usually in breast cancer) and surgery are some of the common cancer treatments. Each type of treatment may increase the likelihood of some type of sexual dysfunction, whether it be pain, decreased sensation, decreased arousal and desire, or vaginal stenosis. Pelvic organ prolapse, a bulging or sensation of something falling in the vaginal canal, can also occur as a result of a shift in organs and or decrease in integrity of the fascia that helps support pelvic organs, and can also lead to pain with sexual activity. There are strategies to help counteract these symptoms, as well as manual therapy to help improve pelvic floor muscle integrity and thus improve symptoms! One systematic review in 2020 found moderate level evidence supporting the rehabilitation of pelvic floor muscles following gynecological cancer treatments.

Physical therapy sessions would incorporate the following to help improve sexual function: 

One study found that an intervention program that consisted of education, manual therapy, specific pelvic floor exercises, development of a home exercise program, and incorporation of a dilator program improved patients’ pain level, pelvic floor symptoms, quality of life, and overall sexual functioning. Remember, you are not alone in experiencing these symptoms and there is help. If you have any questions sexual function and cancer or any other topics, no matter where you are in your journey, it is not too late to seek help from a pelvic floor physical therapist. 

References:

  1. Arthur SS, Dorfman CS, Massa LA & Shelby RA. Managing female sexual dysfunction. Urologic Oncology. 2021; 1-7. https://doi.org/10.1016/j.urolonc.2021.06.006                 
  2. Brennen R, Lin KY, Denehy L & Frawley HC. The Effect of Pelvic Floor Muscle Interventions on Pelvic Floor Dysfunction After Gynecological Cancer Treatment: A Systematic Review. Phys Ther. 2020;100:1357-1371.
  3. Chang YC, Chang SR, Chiu SC. Sexual Problems of Patients With Breast Cancer After Treatment. A Systematic Review. Cancer Nursing 2019; 42(5): 418-425.
  4. Cyr MP, Dumoulin C, Bessette P, Pina A et al. Feasibility, acceptability and effects of multimodal pelvic floor physical therapy for gynecological cancer survivors suffering from painful sexual intercoures: A multicenter prospective interventional study. Gynecologic Oncology 159 (2020) 778-784. 
  5.  Wood F. Human Sexuality in Health and Illness. 3rd ed. St Louis, MO: C.V. Mosby; 1984.

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What Our Patients Have to Say

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Testimonial by M.M.

My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

Read more: Testimonial by M.M.

Testimonial by Y.L. (mom of 2)

After having my second baby via C-section I searched for months to try to find help for my lower back pain and separated abdominal muscles. I finally came across Heather Jeffcoat via a mommy blog. I reached out to her via email and set my first appointment. My first appointment went amazing … she listened to what my symptoms, check my separation and explained to me in detail what the next steps would be. Not only did my abdominal separation go from 3 to about 1 -1/2 but my back has pain has significantly reduced. I’m personally recommending all my mommy friends to Heather!

Y.L. (mom of 2)

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

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