Sexual Medicine Reviews

Female Sexual Dysfunction in Women After Treatment of Cervical Dysplasia

Cervical cancer is the fourth most common cancer worldwide and accounted for approximately 570,000 new cancer cases and 311,000 cancer deaths in 2018. Despite advances in screening algorithms many US women undergo excisional cervical procedures for the treatment of cervical dysplasia. The effects of loop electrosurgical excisional procedure (LEEP) and cold knife conization (CKC) on sexual function are relatively unknown. To conduct a comprehensive review of the literature regarding the effects cervical cancer screening and treatment on female sexual function and satisfaction METHODS: We conducted a review of the medical literature up to and including November 2021 on PubMED using search terms related to cervical dysplasia and sexual health. We identified 831 articles and selected 39 articles for inclusion in our review. Nine studies were included that specifically focused on the effect of loop electrosurgical excisional procedure (LEEP) on female sexual function. Multiple studies demonstrated adverse psychologic and sexual effects in patients with cervical dysplasia and after colposcopy. Some studies reported that women experience decreased arousal and interest 6 months following colposcopy. Several studies documented adverse effects on lubrication, sexual pain, and desire following LEEP. There is a lack of high quality research on the effect of LEEP and colposcopy on female sexual function. Important limitations in the review of the current literature include, a small sample size, inconsistent comparison groups, observer bias, and lack the use of standardized questionnaires. Clinicians should continue to provide patients education regarding the risks and benefits of different treatment modalities and potential for effects on sexual function should be included in comprehensive counseling. Ethan Litman. Female Sexual Dysfunction in Women After Treatment of Cervical Dysplasia. Sex Med Rev 2022;10:360-366.

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.

Cervical Cancer Screening: Past, Present, and Future

ABSTRACTIntroductionCervical cancer is the leading cause of cancer deaths in women in the developing world. New technologies have been developed to allow for more rapid, cost-effective, and sensitive cervical cancer screening and treatment.AimThe aim of this study was to describe methods for detection and treatment of human papillomavirus (HPV), cervical dysplasia (CD), and cervical cancer. New technologies and updated screening strategies will be emphasized.MethodsA literature search was conducted using PubMed to identify publications relevant to the subject.Main Outcome MeasureSensitivity and cost-effectiveness of new cervical cancer screening methods were the main outcome measures.ResultsHPV and cervical cancer have a significant global impact. Research and innovations related to detection and treatment are key in reducing their burden worldwide.ConclusionScreening a woman for HPV and CD can dramatically decrease her risk of dying from cervical cancer. New, rapid, low-cost, HPV testing can allow for high-volume screening for the approximately 1.5 billion women who have never been screened. HPV screening can then be combined with high resolution digital colposcopy to detect CD. In the near future, these colposcopic images will be interpreted by artificial intelligence software. Detected lesions can then be treated easily and effectively with thermocoagulation. This see-and-treat model is a sensitive, efficient, and low-cost vision for the future.

Is Evidence Based on What We Know or Do Not Know? Secrets of the Cervix