Let's talk about sex: consensus guidelines of the GINECOR working group of the Spanish Society of Radiation Oncology: clinical recommendations after pelvic radiotherapy.

Abstract

Purpose: This consensus statement was developed by the GINECOR working group on behalf of the Spanish Society of Radiation Oncology (SEOR) to address the management of sexual health in patients with gynaecological cancer following pelvic radiotherapy. Methods: A modified two-round online Delphi study was conducted with the participation of an expert panel composed of radiation oncologists, nurses, and a gynaecologist. The panel evaluated aspects related to diagnosis, treatment, and follow-up of sexual health issues. The GRADE criteria were applied to assess the level of agreement and support evidence-based recommendations. Results: The resulting consensus recommendations focus on both diagnosis and treatment, emphasizing the use of patient-reported outcome measures (PROMs). Key recommendations include the systematic evaluation of genitourinary, gastrointestinal, and sexual symptoms, as well as the implementation of pharmacological treatments (e.g., vaginal lubricants, hormone therapy) and mechanical options (e.g., vaginal dilators, vibrators). These guidelines reflect both current scientific evidence and expert clinical experience. Conclusion: This consensus statement presents a comprehensive, multidisciplinary approach aimed at improving the sexual health and quality of life of patients with gynaecological cancers after pelvic radiotherapy. It provides specific, actionable recommendations and highlights the importance of regular, patient-centered assessment and specialized care in the management of sexual health concerns in this patient population.