General Factors Affecting Sexual Functioning
Psychosocial Aspects of Sexuality
Medical Aspects of Sexuality

Sexual function is an important factor that adds to quality of life. Patients should discuss their problems and concerns about sexual function with their doctor. Some doctors may not have the appropriate training to discuss sexual problems. Patients should ask for other information resources or for a referral to a health care professional who is comfortable with discussing sexuality issues.

When a possible sexual problem is identified, the health care professional will do a detailed interview either with the patient alone or with the patient and his or her partner. The patient may be asked any of the following questions about his or her current and past sexual functioning:

• How often do you feel a spontaneous desire to have sex?



• Do you enjoy sex?



• Do you become sexually aroused (for men, are you able to get and keep an erection, or for women, does your vagina expand and become lubricated)?



• Are you able to reach orgasm during sex? What types of stimulation can trigger an orgasm (for example, self-touch, use of a vibrator, shower massage, partner caressing, oral stimulation, or intercourse)?



• Do you have any pain during sex? Where do you feel the pain? What does the pain feel like? What kinds of sexual activity trigger the pain? Does this cause pain every time? How long does the pain last?



• When did your sexual problems begin? Was it around the same time that you were diagnosed with cancer or received treatment for cancer?



• Are you taking any medications? Did you start taking any new medications or did the doctor change the dose of any medications around the time that these sexual problems began?



• What was your sexual functioning like before you were diagnosed with cancer? Did you have any sexual problems before you were diagnosed with cancer?

Patients may also be asked about the significance of sexuality and relationships whether or not they have a partner. Patients who have a partner may be asked about the length and stability of the relationship before being diagnosed with cancer. They may also be asked about their partner's response to the diagnosis of cancer and if they have any concerns about how their partner may be affected by their treatment. It is important that patients and their partners discuss their sexual problems and concerns and fears about their relationship with a health care professional with whom they feel comfortable.

Patients may be asked about current and past medical history since many medical illnesses can affect sexual function. Lifestyle risk factors such as smoking and high alcohol intake can also affect sexual function as well as prescribed and over-the-counter medications. Patients may be asked to fill out questionnaires to help identify sexual problems and may undergo a variety of physical examinations, blood tests, ultrasound studies, measurement of nighttime erections, and hormone tests.

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