Sexual dysfunction is common in patients who are undergoing diagnosis of and treatment for gynecologic malignancies. This is due to pain, discomfort, bleeding, and/or psychological stress that may make intimacy difficult. Sexual disorders are typically not screened for effectively, thus masking the problem. Even for patients in whom sexual dysfunction is identified, there is little support to manage the problem. Comprehensive screening questionnaires have been validated as effective screening tools for different sexual disorders. Sexual disorders can be classified into four disorders: desire disorder, arousal disorder,orgasm disorder, and pain disorder. Ovarian protection during chemotherapy has been investigated. It is important to discuss the risk of infertility and fertility preservation options in those patients anticipating cancer treatment. Address fertility preservation as early as possible before treatment starts. The ovaries are the most radiosensitive organs; w only 5 to 15 Gy of radiotherapy causes sterility.
Cancer occurs in one woman per every 1,000 live births, with approximately 4,000 cases of concurrent pregnancy and maternal malignancy each Y. The most common cancer in pregnancy is breast cancer. The most common cancer of the female reproductive system in pregnancy is cervical cancer. If a malignancy is diagnosed after fetal viability, treatment can be delayed until the late second trimester, third trimester, or after delivery, depending on the specific clinical situation. XRT has different effects on a fetus depending on the stage of fetal development at the time of radiation exposure. Chemotherapy should be discontinued at 35–36 weeks’ gestational age to allow for a 3-week period for cytopenias to resolve before delivery. Cervical cancer occurs in approximately 1.4– to 4.6 per 100,000 pregnancies. Ovarian neoplasms are detected at 0.2 to 3.8 cases/100,000pregnancies. Other gynecologic malignancies are quite rare during pregnancy such as vaginal cancer, vulvar cancer, and endometrial cancer.
