Document Type : Letter to the Editor (Policy Brief)

Authors

1 Student Research Committee, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.

2 Assistant Professor, Department of Obstetrics and Gynecology, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.

3 Associated Professor, Department community medicine, Leishmaniasis research Center, faculty of medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.

4 Assistant Professor, Non-Communicable Diseases Research Center, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran.

Abstract

Abstract
Sexual dysfunction is a highly prevalent yet often neglected consequence of breast and gynecologic cancers, significantly affecting patients’ quality of life, marital satisfaction, and treatment adherence. A recent cross-sectional study conducted in Sabzevar (2023) involving 223 women with breast and gynecologic cancers revealed that over 93% experienced sexual dysfunction. This policy summary integrates national and international guidelines to formulate practical recommendations. The proposed policy framework recommends integrating educational and screening programs into oncology services, facilitating referrals, and ensuring financial coverage for sexual healthcare during and after treatment.  Implementation requires a multi-faceted approach: designing culturally adapted programs to overcome barriers, securing sustainable funding and specialized training from an organizational standpoint, and support through national clinical guidelines and legislation to ensure lasting change.

Keywords

Main Subjects

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;68(6):394-424.DOI:3322/caac.21492.
  2. Bennett N, Incrocci L, Baldwin D, Hackett G, El-Zawahry A, Graziottin A, et al. Cancer, benign gynecology, and sexual function—issues and answers. The journal of sexual medicine. 2016;13(4):519-37.DOI: 1016/j.jsxm.2016.01.018
  3. Panjari M, Bell RJ, Burney S, Bell S, McMurrick PJ, Davis SR. Sexual function, incontinence, and wellbeing in women after rectal cancer—a review of the evidence. The journal of sexual medicine. 2012;9(11):2749-58.DOI: 1111/j.1743-6109.2012.02894.x
  4. Fischer OJ, Marguerie M, Brotto LA. Sexual function, quality of life, and experiences of women with ovarian cancer: a mixed-methods study. Sexual medicine. 2019;7(4):530-9.DOI: 1016/j.esxm.2019.07.005
  5. İzci F, Özdem G, İlgün AS, Ağaçayak F, Duymaz T, Erdoğan Z, et al. Pre-treatment and post-treatment anxiety, depression, sleep and sexual function levels in patients with breast European journal of breast health. 2020;16(3):219.DOI: 10.5152/ejbh.2020.5259
  6. Mikkelsen TB, Sørensen B, Dieperink KB. Prediction of rehabilitation needs after treatment of cervical cancer: what do late adverse effects tell us? Supportive care in cancer. 2017;25(3):823-31.DOI: 1007/s00520-016-3466-x
  7. Mohammad Habibi Alleyabad NF, Vahideh MoghaddamHosseini, Mahboubeh Neamatshahi, Seyed Alireza Javadi Nia. Investigation of the Frequency of Sexual Dysfunction and Related Factors in Patients with Breast, Reproductive, and Colorectal Cancers Visiting Vasesi Hospital in Sabzevar in 2023: Sabzevar University of Medical Sciences 2025.
  8. Rahmanian F, editor Investigating factors affecting the quality of sexual life of women with cancer in Shiraz. the fourth national congress of women's cancers in Iran, Tehran. Available at: com/doc/421336.
  9. Ameri A, Novin K, Sourati A, Rashidi P. Awareness of female cancer patients about the risk of impaired fertility. Journal of adolescent and young adult oncology. 2019;8(3):342-8. DOI:1089/jayao.2018.0112
  10. Madihi A, Nakhi Z. Familiarity with the Law on Family and Youth Protection. Behvarz Quarterly. 2022;1401(33):112.DOI: 22038/behv.2022.62700.1434
  11. Chow KM, So WKW, Choi KC, Chan CWH. Sexual function, psychosocial adjustment to illness, and quality of life among Chinese gynaecological cancer survivors. Psycho‐Oncology. 2018;27(4):1257-63.DOI: 1002/pon.4663
  12. Peleg Nesher S, Luria M, Sartorius G, Tripodi F, Lew-Starowicz M, Both S, et al. Clinical practice guidelines: sexual dysfunction in gynecological cancer patients. Sexual Medicine. 2025;13(4).DOI: 1093/sexmed/qfaf0066.
  13. Pizetta LM, da Cunha Reis A, Méxas MP, de Almeida Guimarães V, de Paula CL. Management strategies for sexuality complaints after gynecologic cancer: a systematic review. Revista Brasileira de Ginecologia e Obstetrícia/RBGO Gynecology and Obstetrics. 2022;44(10):962-71.DOI: 1055/s-0042-1756312
  14. Lamyian M, Azin SA, Mohammadi E. Development and validation of clinical practice guidelines to provide sexual and reproductive health services for breast cancer survivors in Iran. Iranian Journal of Breast Diseases. 2024;17(3):33-54.DOI: 61186/ijbd.17.3.33
  15. Roshandel S, Lamyian M, Azin SA, Haghighat S, Mohammadi E, Akbari M. The Provision of Sexual Health Services to Breast Cancer Survivors in Iran: A Qualitative Study. Iranian Journal of Breast Diseases. 2023;16(1):65-84.DOI: 30699/ijbd.16.1.65