Table 1.

Study characteristics

Author (year)	Aim	Sample (n, age, cancer, treatment, country)	Design
Afiyanti and Milanti (2013)	To explore numerous physical sexual concerns and their impact on the intimate partner relationships experienced by CCs in Indonesia	n = 13. 38–48. CC. CT-RT. Indonesia	Qualitative—in-depth interviews
Bakker et al. (2015)	To identify determinants of patients’ adherence with dilator use after EBRT/BT	n = 30. 32–67. CC (n = 29) + VAC (n = 1) CT EBRT/BT. Netherlands	Qualitative—semi-structured interviews
Barlow et al. (2014)	To describe women’s experiences of sexuality and body image following treatment for early-stage VC	n = 10. 37–76. VC. Early-stage. Conservative surgical resection. Australia	Qualitative—semi-structured interviews
Jefferies and Clifford (2011)	To explore the experiences of women with VC living in the UK	n = 13. < 50. VC. Surgery. UK	Qualitative—semi-structured interviews
Jeppesen et al. (2015)	To identify short-term rehabilitation needs of women diagnosed with CC or EC	n = 96. EC (n = 52, median 66.5) + CC (n = 44, median 45). All stages. Surgery ± RT/CT and RT/CT only. Denmark	Qualitative—semi-structured interviews. Questionnaire pre-treatment + 3 months. Focus group (n = 16)
Lloyd et al. (2014)	To explore women’s lived experiences up to 10 years after a radical vaginal trachelectomy, focussing on the impact on health (physical, emotional, social and functional domains), fertility, sexuality and exploring longer term supportive care needs	n = 12. 29–45. CC. 1B1. Vaginal trachelectomy. UK	Qualitative—semi-structured telephone interviews
McCallum et al. (2012)	To describe sexual health as defined by women treated for GC, to obtain a clearer understanding of the nature of desired services among this patient population; and to identify potential barriers to participation in interventions focusing on sexuality	n = 15. 26–71. GC treatment. RT and not. Pre- and post-menopausal at diagnosis	Qualitative—semi-structured interviews
Molassiotis et al. (2002)	To evaluate the adaptation issues faced by GCS within their cultural context	n = 18. 21–64. CC (n = 7), OC (n = 8), EC (n = 3). China	Qualitative—open-ended interviews
Perz, Ussher and Gilbert (2013)	To explore the complex perspectives that people with personal and professional experience with cancer hold about sexuality in the context of cancer	n = 116. (n = 44 patients, n = 35 partners, n = 37 HPs working in oncology). Mixed cancer types, stages, gender and sexual orientation. Australia	Qualitative—semi-structured interviews. Q methodology. Part of a mixed-methods cross-sectional project
Pinar et al. (2016)	To determine the prevalence of SD and affecting factors in women with GC	n = 230. Mean: 48.2. GC. I, II or III. CT, RT and surgery. Turkey	Cross-sectional (n = 230), and qualitative in-depth interviews (n = 20)
Stead et al. (2007)	To explore the impact of OC and its treatment on SF; to estimate the nature of sexual changes; to identify the potential underlying causes or factors associated with sexual problems and their relationship with each other; to provide topics/issues for further research	n = 15. OC	Qualitative—semi-structured interviews
Vermeer et al. (2016)	To assess experiences with SD, psychosexual support, and psychosexual healthcare needs among CCS and their partners	n = 42. CC (n = 30) and partners (n = 12)	Qualitative—semi-structured interviews. Demographic and treatment data previously collected and medical records
Wiljer et al. (2011)	To pilot test a web-based support group for women with psychosexual distress due to GC	n = 27. Randomly assigned intervention (n = 13) or waitlist (n = 14). GC. Surgery, CT, and/or RT. Canada	Qualitative—semi-structured telephone interviews
Williams, Hauck and Bosco (2017)	To gain insights into how Western Australian nurses conceptualise the provision of psychosexual care for women undergoing GC treatment and how this aligns with nurses globally	n = 17. Nurses. Australia	Qualitative—1-on-1 interviews
Zeng, Li and Loke (2011)	To explore the meaning of QoL among Chinese CSC and the impacts of CC survivorship on these women’s QoL	n = 35. CC. Primary treatment. China	Qualitative—written responses
Brotto et al. (2012)	To evaluate a mindfulness-based cognitive behavioural intervention for SD in GCS compared to a wait-list control group	n = 31. 31–64. CC and EC (n = 22 treatment). Wait-list control (n = 9). Hysterectomy ± RT or CT	RCT
Carter et al. (2012)	To explore SF items of early-stage EC patients surgically treated on LAP2. Patterns associated with participants who did and did not respond to these items within the QoL survey will also be examined	Ancillary data study	RCT—patients were randomized to laparoscopy compared to laparotomy groups
Classen et al. (2013)	To determine whether GC patients would participate in a RCT of an online support group that addresses psychosexual concerns of GC patients and to determine their rates of participation	n = 27. GC. Treatment or wait-list control. Surgical, medical, and/or RT. Min. score required of 24 on the FSDS-R	RCT—feasibility study of a 12-week online intervention. Assessment at baseline and completion
Hofsjö et al. (2018)	To investigate the morphology of the vaginal epithelium in CCS treated with RT and its correlation to serum levels of sex steroid hormones and SF	n = 71. < 51 (mean age for menopause in Sweden). CC (n = 34) control (n = 37, no history of cancer, pre-menopausal). RT, primary or with surgery and/or CT. Sweden	RCT—all biopsies and sections—blinded. Questionnaire based on in-depth interviews and validated face-to-face
Li et al. (2016)	To investigate the effect of a home-based, nurse-led health program on QoL and family function for post-operative patients with early-stage CC	n = 226. CC. IA to IIA. No RT and/or CT. Intervention compared to control: living in rural areas, higher monthly income	RCT
Aerts et al. (2009)	To examine the prevalence of SD and psychological functioning in women who underwent pelvic surgery for GC	n = 89. 36–62. GC. Pelvic surgery for VC, CC or EC (n = 50). Healthy age-matched control (n = 39, ≥ 18). Belgium	Case–control—randomly selected
Aktaş and Terzioğlu (2015)	To investigate the effect of home care service on the sexual satisfaction of patients with GC	n = 70. Average: 49.3. GC. Intervention (n = 35) 44.3% II or III OC. 62.9% abdominal gyn surgery and CT. 91.4% RH (type III). Control (n = 35)	RCT (analysed as case–control). Intervention group provided with the nursing care service through hospital and home visits 1st and 12th weeks
Carta et al. (2014)	To compare sexuality in women who had been treated by RH and pelvic lymphadenectomy alone for benign conditions, with those who had received adjuvant pelvic RT for cancers	n = 40. 34–84. EC or CC. > IA. Laparotomic RH with lymphadenectomy and adjuvant RT. No HRT. EBRT. Italy	Case–control
Corrêa et al. (2016)	To evaluate the SF of women diagnosed with invasive CC that have completed the treatment for at least 3 months; identify the variables associated to SF and compare it to a control group composed by women with no cancer history	n = 74. Invasive CC (n = 37). Control (n = 37)	Case–control
DeMelo-Ferreira et al. (2012)	To investigate the occurrence and severity of lymphedema of the lower extremities (LLE), QoL, urinary and SD in women with VC submitted to surgical treatment	n = 56. 40–86. VC (n = 28) vulvectomy and inguinofemoral lymphadenectomy. Healthy, age-matched controls (n = 28). Groups compared for marital/ educational/ menopausal status, hormone therapy and height. Weight/BMI higher in controls	Case–control
Mayer et al. (2018)	To analyse SA, SF and QoL in patients after completion of treatment for breast cancer (72) and OC	n = 549. 18–70. BC (n = 396). OC (n = 93). Healthy controls (n = 60)	Case–control—retrospective multicentre study. Survey 24 + months after diagnosis and compared to controls
Aerts et al. (2015)	To prospectively investigate sexual adjustment of women with EC during a follow-up period of 2 years after surgical treatment and to compare results with women who underwent a hysterectomy for a benign gyn. condition and healthy control women	n = 252. EC (n = 84). Benign gyn condition (n = 84). Healthy controls (n = 84)	Cohort—survey
Armbruster et al. (2016)	To perform a secondary analysis of a 6-month exercise intervention in EKES to determine intervention's impact on sexual health	n = 63. 58.1	Cohort—secondary analysis of the Steps to Health study. Laboratory assessments at baseline, 2, 4, and 6 months
Bakker et al. (2017)	To investigate the feasibility of a nurse-led sexual rehabilitation intervention targeting sexual recovery and vaginal dilatation	n = 20. 26–71. CC (n = 18, 90%), VC (n = 1, 5%), or EC (n = 1, 5%). Vaginal estriol 3 times/week × 6 weeks from 2–8 weeks after RT (n = 16) and HRT (n = 14)	Cohort—prospective, longitudinal, observational pilot study. Non-randomized. 4 face-to-face counselling sessions at 1, 2, 3, and 6 months after completion of EBRT/BT + evaluation at 12 months
Barraclough et al. (2012)	To describe the rates of patient-reported late toxicity elicited. The second aim was to analyse the efficacy of the questionnaire and enable appropriate alteration of some questions	n = 226. GC. Radical or adjuvant pelvic RT	Cohort—patient-reported outcome data collected prospectively before + up to 3 years after RT. Questionnaire for pelvic symptoms
Bretschneider et al. (2017)	To report the perioperative trends of changing sexual interest and desire in a cohort of women undergoing surgery for suspected GC	n = 185 final cohort. GC. USA	Cohort—ancillary analysis of a prospective longitudinal hospital-based cohort study. Standardized, validated questionnaires via computer assisted telephone interviews
Ferrandina et al. (2014)	To prospectively, and longitudinally assess QoL and emotional distress in a large series of EC patients	n = 132. EC. RH + bilateral salpingo-oophorectomy (pelvic lymphadenectomy). Patients with metastatic involvement of pelvic lymph nodes also had paraaortic lymph node dissection	Cohort—prospective, longitudinal. Baseline questionnaire within 1 week of diagnosis and at 3, 6, 12 and 24 months after surgery
Jensen et al. (2003)	To investigate the longitudinal course of self-reported SF and vaginal changes in patients disease free after RT for locally advanced, recurrent, or persistent CC	n = 433. 20–29 (60%). 70–75 (36%). Age- and menopausal status-matched control group. 118 patients referred for RT. Denmark	Cohort—mailed questionnaire at the termination of EBRT and 1, 3, 6, 12, 18, and 24 months after RT
Jones et al. (2016)	To measure the long-term impact of surgical treatment for VC upon HRQoL and pelvic floor outcomes during the first year of therapy	n = 23. Age: > 18. New diagnosis of VC. Mean age: 59.9 (range: 23.8–86.6). Mean BMI: 30.0 (range: 24.4–38.2). 16 women had early (Stage 1 to 2B), and 7 women had advanced stage disease (Stage 3 to 4B). UK	Cohort—prospective, longitudinal, mixed methods. Questionnaires at baseline (pre-treatment) and at 3, 6, 9 and 12-month post-treatment
Juraskova et al. (2012)	To explore the following: (i) the relative importance of quantity vs. quality of sexual life over the first year post-treatment; (ii) the psychological and sexual predictors of overall SF; and (iii) the relationship between SF and QoL	n = 53. CC or EC. I or II. Surgery with or without bilateral salpingo-oophorectomy. Australia	Cohort—mailed questionnaires at 6 and 12 months after completion of baseline assessment
Juraskova et al. (2014)	To investigate objective and subjective aspects of sexual adjustment for women with early stage CC and EC during the first 6-month post-treatment, compared to women with benign and pre-invasive gyn. Conditions	n = 165. Early stage CC and EC (n = 53); benign (n = 60); Pre-invasive (n = 52). Australia	Cohort—multi-centre controlled study. CC and EC with benign (physical effects of major pelvic surgery) and with pre-invasive (emotional effect of the perceived threat of cancer)
Komblith et al. (2007)	To test whether there were significant differences in adjustment between younger and older breast cancer survivors (BCS) and ECS	n = 252. 18–55 (group 1) and 65 + (group 2). USA	Cohort—telephone interviews at study entry (n = 252) and 12 months (n = 226)
Lalos, Kjellberg and Lalos (2009)	To seek information about the occurrence of urinary, climacteric and sexual symptoms in women with CC before and 1 year after therapy for CC without BT	n = 39. 26–64. CC. IA (n = 5), IB (n = 30), IIB (n = 1), IIIB (n = 3). External RT (preop n = 3, postop n = 13) CT (preop n = 1, postop n = 4), RH + resection of the pelvic lymph nodes (n = 32), RH + bilateral salpingo-oophorectomy (n = 7). Sweden	Cohort
Mantegna et al. (2013)	To provide an updated analysis of previously published data, describing the longitudinal modifications of anxiety/ depression and QoL scores, in a large cohort of CC patients who remained disease-free 2 years from diagnosis. We identify also the clinic-pathological and socio-demographic features influencing emotional distress and QoL levels	n = 227. CC. IB–IIA. RH + pelvic lymphadenectomy. Locally advanced (IB–IIA, IIB–IVA) CT/RT followed by RS	Cohort—prospective, longitudinal
Pieterse et al. (2006)	To evaluate the problems with voiding, defecation and sexuality after a RH with or without adjuvant RT for the treatment of CC Stages I–IIa. To determine the prevalence of lymphedema, bladder dysfunction, colorectal motility disorders and SD	n = 94. (all questionnaires n = 73, data not available n = 21). CC treated by RHL. Age-matched controlled women. Compared patients who underwent adjuvant RT to those who did not	Cohort—observational longitudinal. Self-reported bladder, defecation, sexual problems with a baseline score
Scanlon et al. (2012)	To determine whether fertility, menopause status, and sexual health were important QoL concerns among pre-menopausal women with cancer and whether oncologists discussed these concerns adequately during treatment planning and long-term follow-up	n = 53. Pre- or peri-menopausal at diagnosis. USA	Cohort—longitudinal. Evaluation of physician–patient discussions addressing the impact of cancer treatment
Segal et al. (2017)	To investigate RT as a risk factor for urinary or fecal incontinence, pelvic organ prolapse, and SD in ECS	n = 213. 20 + . EC. USA	Cohort—mailed survey and medical record. Incidence rates of pelvic floor disorders compared across groups with different exposures to RT. AOR (adjusted for age, race, BMI, parity, Charlson Comorbidity Index and menopausal status)
SungUk et al. (2017)	To evaluate the global health status of long-term CCS who survived for more than 4 years after curative RT	n = 303. CC. Disease status and late toxicities (n = 303). QoL assessment (168/300). Concurrent CT + RT using 3D conformal EBRT. Age-matched controls for Q oL. Korea	Cohort—QoL questionnaire during follow-up visits
Vaz et al. (2011)	To evaluate QoL in GCS after RT, investigate the frequency of adverse events and demonstrate an association between these symptoms and QoL	n = 95. 21–75. CC and EC. Pelvic RT. Brazil	Cohort—prospective
Wang et al. (2018)	To assess the morbidity of SD in women following different types of RH and to conduct multivariate logistic regression analysis of patients’ SD	n = 125. CC, IA2–IIB. EC, II. RH (n = 25), modified RH (n = 70), and nerve-sparing RH (NSRH, n = 30). China	Cohort—preoperative, and 1- and 2-year post-operative SD rates. Interviews during follow-up visits
Yavas et al. (2017)	To evaluate the emotional, sexual and HRQoL concerns of women with GC treated with curative RT	n = 100. GC. Turkey	Cohort—updated analysis of published data on the longitudinal modifications of HRQoL scores and emotional status during 2-year follow-up. All tests at baseline and 3, 6, 9, 12, 15, 18, and 24 months after RT