In order to talk about sexual health, it will be important to set up definitions. Here we will define sexual health using the World Health Organization definition. We will then describe how to think about sexual health in women, and how cancer and its treatments impact them.

There is a tendency for cancer care specialists to lump all hormone therapies into one category, with blanket recommendations (often that are contraindicated). This lecture will review the evidence basis of estrogen, progesterone, and testosterone as it relates to sexual health for people without cancer and then the implications of these data for people after a cancer diagnosis.

The loss of estrogen, changes in body image and sexual self-identity due to surgery, radiation, chemo- and adjuvant therapies after cancer cause distress for many women, both those who are in a couple and those who are not.

This session will provide a comprehensive overview of the bio-psycho-social challenges that women face and the importance of addressing these, no matter what specific cancer the woman has been treated for.

When we discuss treatments for sexual health in the context of cancer, our goals are complementary: to heal and to comfort. We will review physiology and national guidelines regarding recommendations. Using these we will explore the pharmacologic options and non-prescriptive evidence-based treatments that are available.

The sexual changes that result for both men and women after treatment for any cancer have the potential to negatively affect the couple’s relationship, regardless of sexual orientation of the couple.

This session will address both how the couple relationship is impacted, both positively and negatively, and how they may find acceptance or facilitate improvement for these changes.

Male sexuality is often reduced to erectile function and intimacy is tied to sexual activity. But after illness it can be more complicated. We will review the interplay between society, health, medication, and partner status using the Katz-Dizon model for male sexuality after cancer.

There is an assumption that male sexuality is simple, an on-off switch, that is focused on erections and sexual performance. This is not accurate and male sexuality is complex and not merely physical.

Building on the Katz-Dizon model of male sexuality after cancer, this session will address other sexual side effects including alterations in body image, performance anxiety, and loss of sexual confidence to provide a more nuanced view of male sexuality.

There are 4 evidence-based interventions to address loss of erections in men after treatment for prostate cancer but little if any evidence of interventions to address the psycho-social changes that accompany changes in or loss of sexual function.

This session will suggest interventions for these changes along with experimental therapies (e.g. PRP, shock wave therapy, etc.) that are not yet supported by robust evidence.

Much of what we understand is based on a heterocentric analysis of sexuality which is often based in those with partners. This session will focus on the issues and the approach to others for which the data is lacking: single people, older individuals, those with physical barriers (e.g. stomas), and those within sexual and gender minoritized communities.