Psychosocial interventions to improve sexual functioning in women with cancer: a systematic review of randomized controlled trials

Author:

Carney Lauren M1,Schnur Julie B1,Morgan Orly2ORCID,Hyun Christine1,Magin Zachary E3,Martin Lily4,Montgomery Guy H1

Affiliation:

1. Center for Behavioral Oncology, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai , New York, NY 10029 , United States

2. Department of Medical Education, University of Miami Miller School of Medicine , Miami, FL 33101 , United States

3. Department of Psychological Sciences, University of Connecticut , Storrs, CT 06269 , United States

4. Levy Library, Icahn School of Medicine at Mount Sinai , New York, NY 10029 , United States

Abstract

Abstract Introduction Many women with cancer struggle with sexual side effects during and after treatment. Although preliminary evidence indicates that psychosocial interventions may be efficacious in improving sexual functioning for women with cancer, no systematic review has summarized the state of the science in this area. Objectives The primary goal of this review was to narratively synthesize the results of randomized controlled trials (RCTs) testing the efficacy of psychosocial interventions to address sexual dysfunction in women with cancer. A secondary goal was to describe the diversity of the included samples (ie, racial/ethnic and sexual minority). Methods Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review was conducted examining RCTs of psychosocial interventions to improve sexual functioning for women with cancer. Articles were identified using MEDLINE, Embase, PsycINFO, and Cochrane CENTRAL. Two reviewers independently assessed each article for inclusion, with a third to resolve discrepancies. Results Seventeen studies were included in the review, 12 of which provided sufficient information to calculate effect sizes. Ten of the 12 studies primarily aimed to improve sexual functioning, all of which demonstrated positive effects on at least 1 outcome of sexual functioning. In the 2 RCTs of psychosocial interventions in which sexual function was a secondary aim, effects were negligible (ds = −0.04 and −0.15). Commonalities among the studies with large effect sizes were that they included education, mindfulness/acceptance, and communication/relationship skills as intervention components. Of note, there was an overall lack of sample diversity across studies, and most studies failed to report the race/ethnicity or sexual orientation of the participants. Conclusion Results support interventions targeting sexual functioning outcomes for women with cancer and suggest that multimodal interventions including education, mindfulness/acceptance, and communication/relationship skills may be most effective. Future research should also focus on examining the efficacy and potential adaptations of extant sexual functioning interventions for underrepresented groups.

Funder

National Cancer Institute

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Urology,Obstetrics and Gynecology,Reproductive Medicine,Endocrinology,Endocrinology, Diabetes and Metabolism,Psychiatry and Mental health

Reference50 articles.

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5. Sexual functioning and self-esteem in women after mastectomy – a single-centre, non-randomised, cross-sectional study;Tarkowska;Contemp Oncol Onkol,2020

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