Introduction In gynecologic-oncological patients problems with their sexuality are latently or manifestly present. It is not only a matter of sexual experience within partnerships but also of dysfunction caused by gynecologic-oncological disease and treatment. As a matter of fact many women look upon their gynecologist as being their first contact person in the coping of sexual problems, which very often stands in contrast to minimal or even no competence on the doctors’ side. Patients very often feel shame and unease when talking directly and frankly about their sexual problems. During the conversation it is most important to find adequate answers to those questions that are merely hidden messages, i.e. to find the right balance between distance and intimacy. Patients’ interviews revealed that 80% definitely wished to be fully informed about possible consequences of the disease and its treatment on their sexuality [1]. In another study [2] it was shown that 41% of the interviewed oncological patients wished to have the possibility to talk about sexuality and 80% demanded written information about potential consequences of their disease and the respective treatment on their sexual life. Talking about sexuality becomes increasingly difficult if patients are severely ill, possibly leading to a situation where the sick body, and consequently also sexuality, is excluded from conversation. But also the contrary is possible, bringing sexuality into focus with the intention to make the patient healthy and vivid. This can be induced both by patients or doctors [3]. As Ringel [4] pointed out: ‘What makes human medicine human is the language, so we should make use of this possibility’. Special emphasis should be laid on sexuality at old age. As a matter of fact, elderly and old women increasingly are seeking gynecological consultation due to sexual difficulties in their partnerships. Such consultations, however, are hindered by feelings of shame and fear, especially the fear of being embarrassed or of embarrassing others. The necessity of talking about sexuality coincides with the incidence of the problem. Vermillion and Holmes [5] showed that 38% of all interviewed patients admitted to have sexual problems, including avoidance, fear, inactivity and orgasm dysfunction. 30% of these women, however, are generally satisfied in their sexual relationship. While inquiring the medical history, gynecologists who regularly ask their patients about sexual activities establish 50% satisfaction. These figures are even more substantiated by interviews with married couples. During these interviews, which were not made in the frame of patients’ contacts, 63% of all women and 40% of all men revealed to have had sexual dysfunction in the past [5].

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© 2002 S. Karger GmbH, Freiburg
2003
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