Understanding the sexual impact of treatment is important for women with colorectal and anal cancer, and support is essential, experts report in a recent Sexual Medicine Reviews study.
The term colorectal cancer refers to cancers of the colon (the large intestine) and the rectum (the lower portion of the large intestine). Anal cancer affects the anus, the area connected to the rectum that allows waste to pass out of the body.
Treatments for these cancers may include surgery, chemotherapy, radiation therapy, or a combination of these approaches. Patients might need a stoma (an opening in the abdomen) so that their waste can pass into a special collection bag.
After treatment, many women feel less desire for sex, experience poor arousal, and have difficulty reaching orgasm. Pain and vaginal dryness are common. Some women struggle with poor body image, feeling less feminine and less attractive. Anxiety may also be an issue. A woman may worry about her partner’s response to a waste bag or whether the bag will leak during intimacy.
To learn more about women’s experiences with sexuality following colorectal and anal cancer treatment, researchers conducted a two-part study.
For the first part, they reviewed 23 medical studies on the effects of colorectal and anal cancer on sexuality. Thirteen of the studies included both men and women; the remaining 10 discussed women only.
Overall, about three-quarters of people with colorectal cancer face sexual problems after treatment, and up to a third don’t engage in sexual activity at all, the authors reported.
The researchers noted that many women did not discuss the sexual aspects of treatment with their healthcare providers; some felt reluctant to bring up the subject. But doing so is important.
“Setting realistic expectations regarding post-treatment function can help healthcare professionals and patients work together to manage symptoms throughout the continuum of care,” the authors wrote.
Women also need social support throughout their cancer experience, the authors said.
In the second part of the study, the researchers interviewed 99 women with a history of colorectal or anal cancer about their sexual experiences.
About two-thirds of the women said they had mild to severe vaginal dryness, and over a third had mild to severe pain during intercourse. Only a third were sexually active.
The researchers also reported that:
- 91% of the women felt “somewhat” or “very” concerned about their sexual or vaginal health.
- Almost half said they lacked confidence about future sexual activity.
- 98% met the criteria for a sexual dysfunction diagnosis based on a standardized assessment.
The authors made several suggestions for women to consider. For example, vaginal lubricants and moisturizers can make sex more comfortable. Pelvic floor muscle exercises might decrease pain. Creams can be used to protect the vulva, especially for women who use pads and pantyliners. And vaginal dilators can help keep the vagina more flexible.
Resources
National Cancer Institute
“Anal Cancer—Patient Version”
https://www.cancer.gov/types/anal
“Colorectal Cancer—Patient Version”
https://www.cancer.gov/types/colorectal
Sexual Medicine Reviews
Canty, Jocelyn, MA, et al.
“Sexual Function in Women with Colorectal/Anal Cancer”
(Full-text. Published online: January 14, 2019)
https://www.smr.jsexmed.org/article/S2050-0521(18)30132-X/fulltext
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