Abstract
Breast cancer is the second most common cancer in women in the US. With advancements in treatments, the life expectancy of breast cancer survivors (BCSs) continues to increase. Sexual dysfunction is a lasting effect of treatment and can impact BCSs’ quality of life. This review examined the impact of different levels (none/low, moderate, and high) of physical activity on sexual outcomes in BCSs. A literature review of PubMed and Scopus restricted to articles published within the last 10 years yielded a total of 326 articles, with nine selected based on inclusion and exclusion criteria. Compared with no physical activity, low, moderate, or high levels of physical activity are effective in improving sexual outcomes in BCSs. Findings were particularly pertinent to sexual pleasure and sexual function. Advanced practice providers (APPs) should recommend physical activity to BCSs and other cancer survivors who are experiencing sexual dysfunction. This paper contributes to the current body of knowledge by offering a unique intervention to address certain aspects of sexual functioning in BCSs.
References
Ambler, D. R., Bieber, E. J., & Diamond M. P., (2012). Sexual function in elderly women: A review of current literature. Reviews in Obstetrics & Gynecology, 5(1), 16–27. https://doi.org/10.3909/riog0156
American Cancer Society. (2025). Breast cancer statistics: How common is breast cancer? https://www.cancer.org/cancer/types/breast-cancer/about/how-common-is-breast-cancer.html
American College of Sports Medicine. (2019). Physical activity guidelines for cancer. https://acsm.org/physical-activity-guidelines-cancer-infographic/
American Heart Association. (2024). American Heart Association recommendations for physical activity in adults and kids. www.heart.org. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
Anderson, D. J., Seib, C., McCarthy, A. L., Yates, P., Porter-Steele, J., McGuire, A., & Young, L. (2015). Facilitating lifestyle changes to manage menopausal symptoms in women with breast cancer. Menopause: The Journal of The North American Menopause Society, 22(9), 937–945. https://doi.org/10.1097/gme.0000000000000421
Boing, L., de Bem Fretta, T., Stein, F., Lyra, V. B., Moratelli, J. A., da Silveira, J., dos Santos Saraiva, P. S., Bergmann, A., Lynch, B. M., & de Azevedo Guimarães, A. C. (2023). Can mat pilates and belly dance be effective in improving body image, self-esteem, and sexual function in patients undergoing hormonal treatment for breast cancer? A randomized clinical trial. Archives of Women’s Mental Health, 26(2), 141–151. https://doi.org/10.1007/s00737-023-01294-4
Boswell, E. N. & Dizon, D. S. (2015). Breast cancer and sexual function. Transitional Andrology and Urology, 4(2), 160–168. https://doi.org/10.3978/j.issn.2223-4683.2014.12.04
Campbell, K. L., Winters-Stone, K. M., Wiskemann, J., May, A. M., Schwartz, A. L., Courneya, K. S., Zucker, D. S., Matthews, C. E., Ligibel, J. A., Gerber, L. H., Morris, S., Patel, A. V., Hue, T. F., Perna, F. M., & Schmitz, K. H. (2019). Exercise guidelines for cancer survivors: Consensus statement from international multidisciplinary roundtable. Medicine and Science in Sports and Exercise, 51(11), 2375–2390. https://doi.org/10.1249/mss.0000000000002116
Carraça, E. V., Rodrigues, B., Franco, S., Nobre, I., Jerónimo, F., Ilharco, V., Gabriel, F., Ribeiro, L., Palmeira, A. L., & Silva, M. N. (2023). Promoting physical activity through supervised vs motivational behavior change interventions in breast cancer survivors on aromatase inhibitors (pac-woman): Protocol for a 3-arm pragmatic randomized controlled trial. BMC Cancer, 23(1). https://doi.org/10.1186/s12885-023-11137-1
Centers for Disease Control and Prevention. (2023). What counts as physical activity for adults. https://www.cdc.gov/physical-activity-basics/adding-adults/what-counts.html
Centers for Disease Control and Prevention. (2025). U.S. cancer statistics breast cancer stat bite. https://www.cdc.gov/united-states-cancer-statistics/publications/breast-cancer-stat-bite.html
Chang, Y. C. (2023). Effectiveness of integrated mindfulness-based fitness training program in ameliorating physical symptoms and survivor concerns in patients with breast cancer. Cancer Nursing. https://doi.org/10.1097/ncc.0000000000001285
Denig, L. A., Boing, L., Fretta, T. de, Sperandio, F. F., & Guimarães, A. C. (2022). Effects of belly dancing intervention on sexual function and body image in breast cancer patients undergoing hormone therapy - randomized clinical trial. Fisioterapia Em Movimento, 35(spe). https://doi.org/10.1590/fm.2022.35602
Fobair, P., & Spiegel, D. (2009). Concerns about sexuality after breast cancer. The Cancer Journal, 15(1), 19–26. https://doi.org/10.1097/ppo.0b013e31819587bb
Higano, C. S., Zarowski, C., Wassersug, R., & Elliott, S. (2016). Sexual health after cancer therapy. Journal of Oncology Practice, 12(4), 305–306. https://doi.org/10.1200/JOP.2016.011536
Joaquim, A., Amarelo, A., Antunes, P., Garcia, C., Leão, I., Vilela, E., Teixeira, M., Duarte, B., Vieira, M., Afreixo, V., Capela, A., Viamonte, S., Costa, H., Helguero, L. A., & Alves, A. (2023). Effects of a physical exercise program on quality of life and physical fitness of breast cancer survivors: The MAMA_MOVE Gaia after treatment trial. Psychology, Health & Medicine, 29(5), 964–987. https://doi.org/10.1080/13548506.2023.2240074
Meston, C. M., Freihart, B. K., Handy, A. B., Kilimnik, C. D., & Rosen, R. C. (2020). Scoring and interpretation of the FSFI: What can be learned from 20 years of use? The Journal of Sexual Medicine, 17(1), 17–25. https://doi.org/10.1016/j.jsxm.2019.10.007
Mollaioli, D., Ciocca, G., Limoncin, E., Di Sante, S., Gravina, G. L., Carosa, E., Lenzi, A., & Jannini, E. A. (2020). Lifestyles and sexuality in men and women: The gender perspective in sexual medicine. Reproductive Biology and Endocrinology, 18(10). https://doi.org/10.1186/s12958-019-0557-9
Paiva, C. E., Rezende, F. F., Paiva, B. S., Mauad, E. C., Zucca-Matthes, G., Carneseca, E. C., Syrjänen, K. J., & Schover, L. R. (2016). Associations of body mass index and physical activity with sexual dysfunction in breast cancer survivors. Archives of Sexual Behavior, 45(8), 2057–2068. https://doi.org/10.1007/s10508-016-0758-7
Roine, E., Sintonen, H., Kellokumpu-Lehtinen, P. L., Penttinen, H., Utriainen, M., Vehmanen, L., Huovinen, R., Kautiainen, H., Nikander, R., Blomqvist, C., & Saarta, T. (2020). Health-related quality of life of breast cancer survivors attending an exercise intervention study: A five-year follow-up. In Vivo, 34(2), 667–674. https://doi.org/10.21873/invivo.11821
Shin, W., Song, S., Jung, S., Lee, E., Kim, Z., Moon, H., Noh, D., & Lee, J. E. (2017). The association between physical activity and health-related quality of life among breast cancer survivors. Health and Quality of Life Outcomes, 15(1). https://doi.org/10.1186/s12955-017-0706-9
Smedsland, S. K., Vandraas, K. F., Bøhn, S. K., Dahl, A. A., Kiserud, C. E., Brekke, M., Falk, R. S., & Reinertsen, K. V. (2022). Sexual activity and functioning in long-term breast cancer survivors; exploring associated factors in a nationwide survey. Breast Cancer Research and Treatment, 193(1), 139–149. https://doi.org/10.1007/s10549-022-06544-0
Vegunta, S., Kuhle, C. L., Vencill, J. A., Lucas, P. H., & Mussallem, D. M. (2022). Sexual health after a breast cancer diagnosis: Addressing a forgotten aspect of survivorship. Journal of Clinical Medicine, 11(22), 6723. https://doi.org/10.3390/jcm11226723
Zdenkowski, N., Tesson, S., Lombard, J., Lovell, M., Hayes, S., Francis, P. A., Dhillon, H. M., & Boyle, F. M. (2016). Supportive care of women with breast cancer: Key concerns and practical solutions. Medical Journal of Australia, 205(10), 471–475. https://doi.org/10.5694/mja16.0094