Abstract
Background: Sexual dysfunction is a common but frequently underrecognized consequence of gynecological cancer treatment. It may persist throughout survivorship and involve vaginal symptoms, dyspareunia, pelvic-floor dysfunction, hormonal changes, psychological distress, altered body image, and relationship difficulties. Despite its substantial impact on quality of life, sexual health is still inconsistently addressed in routine follow-up care.
Objective: This narrative review evaluates contemporary treatment strategies for sexual dysfunction in gynecological cancer survivors and proposes a personalized framework for multidisciplinary oncosexual rehabilitation.
Methods: A narrative literature search was conducted in PubMed/MEDLINE, Scopus, and Google Scholar, focusing primarily on publications from January 2016 to September 2026. Randomized controlled trials, observational and qualitative studies, systematic reviews, meta-analyses, clinical guidelines, consensus statements, and relevant narrative reviews were considered. Earlier landmark studies were retained when clinically relevant.
Results: Current evidence supports a multidimensional approach to treatment. Management should begin with structured assessment of sexual symptoms, cancer and treatment history, vaginal and hormonal status, pelvic-floor function, psychological well-being, body image, relationships, and patient-defined goals. Therapeutic options include vaginal moisturizers and lubricants, selected local hormonal treatment, vaginal dilators, pelvic-floor rehabilitation, psychosexual and psychological interventions, and multidisciplinary survivorship care. Evidence for individual interventions varies, and emerging approaches such as vaginal laser therapy require further evaluation. The available literature supports combining interventions according to the predominant mechanisms and individual needs.
Conclusions: Sexual dysfunction should not be regarded as an unavoidable consequence of gynecological cancer survivorship. Personalized, mechanism-based treatment integrated with multidisciplinary oncosexual rehabilitation offers a clinically meaningful approach to restoring sexual comfort, intimacy, confidence, and quality of life.