Sexual dysfunction and anxiety disorders among women surviving gynecologic malignancies: a cross-sectional study

Gynecologic cancer survivors frequently experience sexual dysfunction and anxiety, which can adversely affect their quality of life. Despite its clinical importance, female sexual dysfunction (FSD) remains underrecognized and undertreated. This study aimed to assess the prevalence of FSD and anxiety, as well as their associated factors, among Thai gynecologic cancer survivors.

This prospective, cross-sectional study was conducted at a university hospital between July 2024 and May 2025. Eligible women aged ≥18 years who had completed treatment for gynecologic cancer at least 6 months prior were recruited. Sexual function was evaluated using the validated female sexual function index (FSFI), with a cutoff ≤26.55 indicating FSD. Anxiety was assessed using the generalized anxiety disorder seven-item scale. Associations with FSD were analyzed using the chi-square test and logistic regression analysis.

Of the 202 eligible women, 160 (79.0%) participated in the study. Most participants were postmenopausal (84.38%) and had an early stage disease (78.12%). The prevalence of FSD was 84.38%, with the lowest FSFI domain scores observed for arousal, lubrication, orgasm, and pain. Anxiety was predominantly mild (77.78%), with only one participant reporting severe symptoms. Multivariable analysis identified age ≥50 years (adjusted odds ratio [OR], 9.84; P<0.001) and alcohol consumption (adjusted OR, 0.25; P=0.033) as independent factors associated with FSD.

FSD is highly prevalent among Thai gynecologic cancer survivors; however, anxiety is generally mild. Routine assessment of sexual health and multidisciplinary management should be considered a part of survivorship care to improve overall well-being.