A couple talks to a doctor about their sexual health.
Sexual pain in women with cancer should only be treated as a psychological problem after physical issues are ruled out. (For Spectrum Health Beat)

Painful sex is common, though often treatable, in women with cancer, yet doctors often overlook it, researchers say.

“Sexual pain is often written off as ‘in people’s heads,’ but it is more often a result of physical issues that can be helped,” said Dr. Vanessa Kennedy, an assistant professor of gynecologic oncology at the University of California, Davis, Health System.

“It is important to be able to have the conversation comfortably and to know how to address the common issues that are often predictable, depending on a patient’s treatment course,” she said in a university news release.

In their review paper, Kennedy and co-author Dr. Deborah Coady, from NYU Langone Medical Center, outlined several causes of painful sex in women with cancer, and listed treatments such as surgery, chemotherapy, radiation and hormone therapy.

A low estrogen level is most often to blame. It usually stems from hormone therapy, ovary removal or radiation to the pelvic region, Kennedy said.

“Diagnosing a purely psychological basis for sexual pain is only appropriate after biologic causes have been completely evaluated and ruled out,” Kennedy added.

She said gynecologists should work with cancer specialists to learn more about the possible effects of a patient’s cancer therapy.

Most women find it hard to bring up sexual difficulties and would prefer their doctors to ask about it, according to Kennedy.

“Time and time again, I see women who have had negative impacts for years following cancer therapy. It’s an incredible relief for them to be able to just sit down and have the conversation,” she said.

The paper was published recently in the journal Obstetrics & Gynecology.