Breast cancer survivors experiencing sexual dysfunction, body image issues, and menopausal symptoms can benefit from Internet-based cognitive behavioral therapy (CBT), a study published in the Journal of Clinical Oncology has shown.1

About 45% to 77% of women experience sexual dysfunction following breast cancer treatment, with the most common problems being reduced sexual desire, sexual arousal, vaginal lubrication, anorgasmia, and dyspareunia. These problems can lead to negative body image and negative feelings of sexual attractiveness and femininity.

To evaluate the effect of Internet-based CBT on sexual functioning, relationship intimacy, body image, menopausal symptoms, marital functioning, psychological distress, and health-related quality of life in survivors with sexual dysfunction, investigators randomly assigned 169 breast cancer survivors to receive Internet-based CBT or a waiting-list control group. 

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CBT comprised weekly therapist-guided sessions for up to 24 weeks. Investigators assessed outcomes using self-report questionnaires at baseline, midtherapy, and post-therapy.

Results showed that patients who underwent CBT displayed a significant improvement over time in overall sexual functioning (P = .031), sexual desire (P < .001), sexual arousal (P = .008), and vaginal lubrication (P = .013) compared with those in the control arm.

In addition, patients in the intervention group reported greater improvement in sexual pleasure (P = .001), less discomfort during sex (P = .001), and less sexual distress over time (P = .001) vs the control group. Patients receiving CBT also reported significantly more improvement in body image (P = .009) and fewer menopausal symptoms (P = .007).

However, investigators observed no significant benefit from Internet-based CBT on health-related quality of life, intercourse frequency, marital functioning, orgasmic function, psychological distress, relationship intimacy, or sexual satisfaction.

Additional research is needed to determine which elements of the CBT confer the most benefit to patients and whether a less intensive or shorter Internet-based intervention can achieve similar outcomes.


1. Hummel SB, van Lankveld JJDM, Oldenburg HSA, et al. Efficacy of Internet-based cognitive behavioral therapy in improving sexual functioning of breast cancer survivors: Results of a randomized controlled trial. J Clin Oncol. 2017 Feb 27. doi: 10.1200/JCO.2016.69.6021 [Epub ahead of print]