Physical sexual concerns and their impact on intimate
partner relationships
Treatments for cervical cancer can result in multiple side effects that can impact on sexual functioning and sexual relationships. These include early menopause symptoms, dyspareunia, and vaginal changes (i.e. shortened vagina, reduced vaginal elasticity, and diminished vaginal lubrication) and decreased sexual activity. These physical concerns may lead to further concerns in the psychological dimension, such as impaired sexual desire, loss of sexual intimacy with the spouse, lack of confidence, anxiety related to sexual performance, and body image disturbances.
Decreased sexual desire may bring difficulty in maintaining previous sexual roles, emotional distancing from the partner, and perceived change in the partner’s level of sexual interest as reported by numerous studies. All of these concerns may eventually be related to disrupted ability in satisfying the sexual desires of the partner of cancer survivors, which may put their marriage at risk. Syse and Kravdal (2007) reported significant increases in divorce rates for women diagnosed with cervical cancer. They reported that the divorce rate in women with cervical cancer was higher than that in any other type of cancer survivors other cancer survivors. The main issue was marriage life caused by lack of sexual desire and satisfaction, both for the patient and her spouse. Such concerns were commonly encountered among women in Asian countries, including Indonesia.
While much has been written about the experiences of North American and European women, little has been discussed in Indonesia about sexuality concerns following cervical cancer treatment. However, there are many indications that survivors may experience stress with this life change. The information about the sexual experiences of cancer survivors among Indonesian women is important because many Indonesian women still hold the value to obey and serve their husband as the sole marital obligation. In Indonesia, sexual encounters are believed to be the duty of the women towards the husbands and are not meant to be pleasurable for the women. Cancer survivors often push themselves to fulfil the sexual desire of their husbands for the sake of their marriage.