Malihe Shams

Female sexuality after gynecological cancer: an updated focused narrative review of recent European and MENA studies (2024-2025): proposal for clinical intervention

Abstract Introduction Gynecological cancer and related oncological treatments can significantly impair female sexual function, negatively affecting patients’ quality of life. However, clinical attention to this issue remains limited, especially in the diverse cultural and healthcare contexts of both Europe and the MENA region. Objective This focused narrative review aims to update and analyze studies published between 2024 and 2025 that investigate sexual function in women with gynecological cancer treated with surgery, chemotherapy, and/or radiotherapy, in order to identify emerging clinical needs. Methods Fifty-seven papers published between January 2024 and February 2025 in Europe and in the MENA region were initially selected as they met established criteria, including the assessment of sexual function as a primary post-treatment outcome. The narrative synthesis included a comparison between geographical and cultural contexts. Given the limited number of eligible studies and the heterogeneity of study designs and outcomes, a narrative synthesis was performed. The review was informed by PRISMA reporting principles, although no formal risk-of-bias assessment was undertaken. Results Most studies showed a deterioration in sexual function after therapy, often associated with physical symptoms and body image disorders. Across European and MENA contexts, convergent patterns emerged, while region-specific differences were less clearly delineated. Conclusions The analysis of studies considered highlights the importance of implementing appropriate psychosexual support interventions in cancer follow-up protocols. The findings support the need for early, structured, and multidisciplinary psychosexual interventions. A conceptual psycho-oncological-sexological care model is proposed as a hypothesis-generating framework for future clinical research and practice, aiming not only to address sexual health but also to enhance overall well-being.