Psychological issues include fear of death, fear of partner's rejection, and fear of disfigurement. Women diagnosed with gynecologic cancer are faced with both physiologic and psychologic effects of treatment. Therefore, the treating physician must communicate early on with the patient about the effects of the disease and its treatment on her sexuality. However, many women are reluctant to ask questions about sex. Once treatment has begun, it is not unusual at all to experience anxiety about future sexual capacity.

When a woman is diagnosed with cancer, initially the shock of the diagnosis has to be dealt with. More studies are needed to clarify the reasons for increased sexual complaints post-hysterectomy. Cervical and endometrial cancer are treated by radical hysterectomy. The physiologic side effects of treatment can be the result of surgery, radiation, or chemotherapy. Of the 355 patients involved in this study, 49 percent reported "no interest in sexual activity" before surgery.

All were undergoing hysterectomies for nonmalignant disorders and were monitored at three, six, and twelve months after surgery. For the women with hysterectomies, the variables that were found to be significant in explaining their sexual satisfaction in the order of relative importance during this study, were the lack of other physiologic health problems, the ability to reframe problems, and the support of family and friends. The results of this study also indicated that hysterectomy was in fact correlated with an increase in sexual complaints at six and twelve months after surgery and again revealed the variations between study groups. Needless to say, this was a very large group of unhappy women in the post-surgery group. "No enjoyment of sexual activity" was reported by 44 percent of the women before surgery while 84 percent reported no enjoyment after surgery. At twelve months after surgery, 75 percent reported the same complaint.