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Herman & Wallace Blog

Sex After Gynecologic Cancer - Part I

The following comes to us from Herman & Wallace faculty member Michelle Lyons. Michelle travels the world spreading the word about pelvic rehabilitation and the powerful benefits it can have on a patient's everyday life. Michelle will be teaching her newest course, "Oncology and the Female Pelvic Floor: Female Reproductive and Gynecologic Cancers" in White Plains, NY this August 14 - 15. Join her to learn more about evaluating and treating oncology patients.

According to the Scientific Network of Female Sexual Health and Cancer, ‘Sexuality is an experience that really is at the intersection of mind, body and relationship, and cancer treatment can impact all three of those elements”. Dr Sharon Bober of Dana Farber says ‘Part of the problem is that doctors are so focused on saving a cancer patient's life that they forget to discuss issues of sexual health. My sense is that it's not about physicians or health care providers not caring about your sexual health or thinking that it's unimportant, but that cancer is the emergency, and everything else seems to fall by the wayside".

If you harness the power of Google to look up female sexual dysfunction after gynaecologic cancer, you may see phrases like ‘Possible sexual side effects…’ or ‘Cancer treatment can cause physical changes that make having sex more difficult’ or even ‘cancer treatments may make intercourse painful’. To call these descriptions ‘understatements’ does not really do them justice.

For many women post-gynaecological cancer, resuming sexual function can be a multi-faceted problem. Issues can range from dealing with Cancer Related Fatigue and nausea, vomiting or diarrhea to physical changes in the size and shape of the vaginal canal. Cancer treatments can also cause hormone imbalances and tissue damage. Add to this issues with post-surgical/radiation adhesions, a disruption to the ability to produce lubrication, challenges to the musculo-skeletal systems within the hips and the pelvis as well as the onset of medically induced menopause….well you get the picture.

In a 2009 paper, ‘Interventions for sexuality after pelvic radiation therapy and gynaecological cancer’, Katz talks about the fact that ‘…very little attention has been paid to the sexual difficulties women experience after radiation to the sexual organs. There are a limited number of interventions for the woman who has been treated for gynaecological cancer with radiation. These focus on the provision of information and some specific suggestions related to treating vaginal dryness, the need for vaginal dilatation after radiation therapy, and management of fatigue. In ‘A systematic review of sexual concerns reported by gynaecological cancer survivors’ (Abbot Anderson 2012), the author points out that common concerns in the physical dimension were dyspareunia, changes in the vagina, and decreased sexual activity.

In the psychological dimension, common concerns were decreased libido, alterations in body image, and anxiety related to sexual performance. And in the social dimension, common concerns were difficulty maintaining previous sexual roles, emotional distancing from the partner, and perceived change in the partner's level of sexual interest.

The good news is that you can return to a normal sex life after surviving gynaecological cancer – particularly with the help of a skilled pelvic rehab provider.

In part 2 of this blog series, I will look at specific interventions in sexual rehab for the gynaecological cancer survivor. Interested in learning more about pelvic rehab and oncology? Join me in White Plains in August!

Women and Sex – After Cancer (Part Two)
Can Physiotherapy Help Primary Dysmenorrhea?

Upcoming Continuing Education Courses

Boundaries, Self-Care, and Meditation - Remote Course

May 22, 2020 - May 31, 2020
Location: Replacement Remote Course

Oncology of the Pelvic Floor Level 1 - Remote Course

May 26, 2020 - Jun 4, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 Part 1 - Remote Course (SOLD OUT)

May 28, 2020 - May 29, 2020
Location: Short Form Remote Course

Pelvic Floor Level 1 - Chicago, IL (RESCHEDULED)

May 29, 2020 - May 31, 2020
Location: Advocate Illinois Masonic Medical Center

Boundaries, Self-Care, and Meditation - Columbus, OH (RESCHEDULED)

May 29, 2020 - May 31, 2020
Location: The Ohio State University Wexner Medical Center

Pelvic Floor Level 2A - Syracuse, NY (RESCHEDULED)

May 29, 2020 - May 31, 2020
Location: SUNY Upstate Medical University

Gender Diversity and Pelvic Health - Livingston, NJ (RESCHEDULED)

May 29, 2020 - May 31, 2020
Location: Ambulatory Care Center- RWJ Barnabas Health

Pelvic Floor Level 2B - Maywood, IL (Rescheduled)

May 29, 2020 - May 31, 2020
Location: Loyola University Health System

Sexual Medicine in Pelvic Rehab - Remote Course

May 30, 2020 - May 31, 2020
Location: Replacement Remote Course

Pregnancy Rehabilitation - Remote Course (SOLD OUT)

May 30, 2020 - May 31, 2020
Location: Replacement Remote Course

Sacroiliac Joint Evaluation and Treatment - Nashua, NH (RESCHEDULED)

May 30, 2020 - May 31, 2020
Location: St. Joseph Hospital Rehabilitative Services

Postpartum Rehabilitation - Foothill Ranch, CA (Rescheduled)

May 30, 2020 - May 31, 2020
Location: Intercore Physical Therapy

Pilates for the Pelvic Floor - Valencia, CA (Rescheduled)

May 30, 2020 - May 31, 2020
Location: Henry Mayo Newhall Memorial Hospital

Building Resilience Through Nourishment

Jun 2, 2020
Location: Short Form Remote Course

Pelvic Floor Series Capstone - Salt Lake City, UT (SOLD OUT)

Jun 5, 2020 - Jun 7, 2020
Location: Rocky Mountain University of Health Professions

Pelvic Floor Capstone - Remote Course

Jun 5, 2020 - Jun 7, 2020
Location: Replacement Remote Course

Pregnancy Rehabilitation - Remote Course (SOLD OUT)

Jun 5, 2020 - Jun 6, 2020
Location: Replacement Remote Course

Pediatric Incontinence - Grand Rapids, MI (RESCHEDULED)

Jun 5, 2020 - Jun 7, 2020
Location: Mary Free Bed Rehabilitation Hospital

Pelvic Floor Level 2A - Kansas City, MO (Rescheduled)

Jun 5, 2020 - Jun 7, 2020
Location: Centerpoint Medical Center

Pelvic Floor Level 1 - Atlanta, GA (RESCHEDULED)

Jun 5, 2020 - Jun 7, 2020
Location: Emory Healthcare

Pelvic Floor Level 1 - Washington, DC (Rescheduled)

Jun 5, 2020 - Jun 7, 2020
Location: The George Washington University

Pelvic Floor Level 1- Canton, OH (Rescheduled))

Jun 5, 2020 - Jun 7, 2020
Location: Aultman Hospital

Restorative Yoga for Physical Therapists - Remote Course

Jun 6, 2020 - Jun 7, 2020
Location: Short Form Remote Course

Pelvic Floor Level 1 Part 1 - Remote Course (SOLD OUT)

Jun 6, 2020 - Jun 7, 2020
Location: Short Form Remote Course

Trauma Informed Care - Remote Course

Jun 6, 2020
Location: Short Form Remote Course

Pelvic Floor Level 1 - Berrien Springs, MI (Rescheduled)

Jun 7, 2020 - Jun 9, 2020
Location: Andrews University

Pelvic Floor Level 2B - Bay Shore, NY (Rescheduled)

Jun 7, 2020 - Jun 9, 2020
Location: Touro College: Bayshore

Pelvic Floor Level 1 Part 1 - Remote Course

Jun 11, 2020 - Jun 12, 2020
Location: Short Form Remote Course