Arousing scientific curiosity.

Consider for a moment just how much data is out there on erectile dysfunction in men as a result of differing cancer therapies for prostate and other cancers. Now ask yourself what you know about erectile dysfunction in women following cancer therapies—heck, about erectile dysfunction in women period. This meta-analysis aimed to review any and all available studies from any time period that investigated any effect of radiation on the function of female erectile tissue (i.e., clitoris and vestibular bulbs) among women receiving radiation for pelvic malignancies. Notably, this is distinct from, broadly speaking, female  “sexual outcomes” that typically centers around ovarian function and/or vaginal stenosis. The real crux of the conclusion can be surmised from the number of studies identified: three, including one guideline study and two nonrandomized studies on intervention effects comprising a grand total of 37 female subjects. Considering some patients would reasonably forgo therapies with marginal advantages in cancer outcomes in order to preserve sexual pleasure, this is an area that clearly needs to be critically analyzed in future prospective trials of female pelvic radiation, as has been the case for male counterparts for decades. | Marshall, CA Cancer J Clin 2022