Addressing Sexual Dysfunction in Serious Illness

Outcomes

1. Participants will self-report the ability to integrate patient-centered language and communication skills to identify common sexual health concerns and sexual dysfunction in patients with serious illness.

2. Participants will self-report the ability to employ pharmacological and non-pharmacological treatments strategies for sexual dysfunction in patients with serious illness.

Key Message

Sexual dysfunction is common in serious illness and has a negative impact on sexuality, intimacy, and quality of life. (1, 2). This session will review common sexual health concerns in patients with serious illness and provide participants with practical assessment, communication, and management strategies for how to address these concerns.

Abstract

Sexual dysfunction and its negative effects on sexuality and intimacy are common in patients with serious illness and can result in decreased quality of life, depression, anxiety, and have a negative impact on relationships. (1-3). Intimacy includes both physical and emotional closeness and the World Health Organization defines sexuality as “a central aspect of being human throughout life” (2). Despite sexual dysfunction occurring in up to 90% of cancer patients and the National Coalition for Hospice and Palliative Care Clinical Practice Guidelines suggesting this be addressed in routine social assessments, palliative medicine providers infrequently discuss these issues with their patients (1). Barriers to these conversations include misperceptions around the importance of this topic, fear of causing offense, and lack of knowledge to guide treatment (2). Data shows that patients want their providers to broach this topic but are unlikely to seek specialized care for sexual dysfunction, despite its significant impact on quality of life (1, 2, 4-5). As a result, this important topic often goes unheard and unaddressed. The term sexual dysfunction includes decreased libido, erectile and ejaculatory dysfunction, and genitourinary symptoms of menopause (GSM). Sexual dysfunction can be caused by the disease process itself, secondary to treatment, or a result of psychological and relationship stresses. In this session, experts in gynecologic, urologic, oncologic, and palliative medicine will utilize a case-based presentation format to offer evidence- and consensus-based guidance on diagnosis and treatment of sexual dysfunction in serious illness. Presenters will review common sexual health concerns and patient-centered communication strategies to diagnosis sexual dysfunction and will discuss current ambulatory, pharmacological and non-pharmacologic treatment interventions. Participants will leave the session with practical assessment, communication, and management strategies for how to address these concerns.

References

1. Walker LM, Sears CS, Booker R, et al. Development, implementation, and evaluation of a multidisciplinary oncology sexual health clinic in a Canadian cancer care setting. J Cancer Surviv. 2021 Oct;15(5):755-766. 2. Kelemen A, Cagle J, Chung J, Groninger H. Assessing the Impact of Serious Illness on Patient Intimacy and Sexuality in Palliative Care. J Pain Symptom Manage. 2019 Aug;58(2):282-288. 3. Vegunta S, Kuhle CL, Vencill JA, Lucas PH, Mussallem DM. Sexual Health after a Breast Cancer Diagnosis: Addressing a Forgotten Aspect of Survivorship. J Clin Med. 2022 Nov 14;11(22):6723. 4. Bramati P, Dai J, Urbauer DL, Bruera E. Attitudes of Palliative Care Specialists Toward Assessing Sexual Dysfunction in Patients With Cancer. J Pain Symptom Manage. 2023 Aug;66(2):e185-e188. 5. van Roij J, Raijmakers N, Johnsen AT, et al. Sexual health and closeness in couples coping with advanced cancer: Results of a multicenter observational study (eQuiPe). Palliat Med. 2022 Apr;36(4):698-707 .