Sexual Dysfunction in Breast and Gynaecological Cancer Survivors: Prevalence, Quality-of-Life Associations, and Sexual Healthcare Experiences

Sexual dysfunction is a frequent but often under-recognised consequence of cancer and its treatment in women, with potential implications for quality of life and survivorship care. This cross-sectional study evaluated sexual dysfunction, health-related quality of life, and sexual healthcare experiences in 246 women with a history of breast and/or gynaecological cancer. Sexual function was assessed using the Female Sexual Function Index and health-related quality of life using the EORTC QLQ-C30. Female Sexual Function Index scores were ≤26.55 in 89.0% of participants, with a mean total score of 14.9 ± 8.94. Lubrication and orgasm were the most impaired domains. In the primary analysis, better physical functioning and lower insomnia were independently associated with better sexual function. In sensitivity analyzes, the insomnia association persisted, while physical functioning estimates were smaller and their confidence intervals included zero: no statistically significant independent associations were detected for age or menopausal status, although these findings require cautious interpretation given the subgroup imbalance. A healthcare professional initiated a discussion about sexuality in 46/246 participants (18.7%). These findings highlight the high prevalence and multidimensional nature of sexual dysfunction after cancer and support more systematic assessment, individualized management, and integration of sexual health into survivorship care.