Abstract: Since the original version of this review we have identified 11 new studies in women. The one study identified in the earlier version of this review was excluded in this update as it did not meet our narrower inclusion criteria to include only interventions for the treatment, not prevention, of sexual dysfunction. In total 1509 female participants were randomised across 11 trials. All trials explored interventions following treatment either for gynaecological or breast cancer. Eight trials evaluated a psychotherapeutic or psycho-educational intervention. Two trials evaluated a pharmaceutical intervention and one pelvic floor exercises. All involved heterosexual women. Eight studies were at a high risk of bias as they involved a sample of fewer than 50 participants per trial arm. The trials varied not only in intervention content but in outcome measurements, thereby restricting combined analysis. In the trials evaluating a psychotherapeutic intervention the effect on sexual dysfunction was mixed; in three trials benefit was found for some measures of sexual function and in five trials no benefit was found. Evidence from the other three trials, two on different pharmaceutical applications and one on exercise, differed and was limited by small sample sizes. Only the trial of a pH-balanced vaginal gel found significant improvements in sexual function. The trials of pharmaceutical interventions measured harm: neither reported any. Only one psychological intervention trial reported that no harm occurred because of the intervention; the other trials of psychological support did not measure harm. Since the last version of this review, the new studies do not provide clear information on the impact of interventions for sexual dysfunction following treatments for cancer in women. The sexual dysfunction interventions in this review are not representative of the range that is available for women, or of the wider range of cancers in which treatments are known to increase the risk of sexual problems. Further evaluations are needed.

Plain-language summary: We identified 11 new trials on interventions for women in September 2015. We excluded one trial that was included in the earlier version of this review because it assessed treatment for preventing sexual dysfunction and was no longer relevant to this review. Interventions differed in their content and how the researchers measured benefit. Eight of the interventions involved psychological support such as counselling on sexual matters, or peer support. One of the others was of a testosterone cream, another tested a vaginal pH-balanced gel and the other was of pelvic floor exercise. The findings from six of the trials are weak because they involved small numbers of women. Across the trials the impact on sexual function was different. This makes it difficult to derive clear conclusions. For instance, in those that evaluated a psychological support treatment, four studies found that it improved some measures of sexual function but not others, but five found that it did not improve sexual function according to any of the measures used. For the other interventions tested, only the trial of the vaginal gel found improvements in sexual function and no side effects were reported. Only one of the psychological interventions reported that no harm occurred because of the intervention. The other trials of psychological support did not assess harm. This is an important gap as some women may find it distressing to discuss personal sexual problems as part of their treatment. Further evaluations are needed for all interventions. Current studies have only explored effectiveness in women with gynaecological and breast cancers, but there is a risk of sexual problems after treatments for other cancers. New evaluations need to involve larger numbers of participants.