Menopause Urogenital Sexual Health and Intimacy Clinic (MUSIC) program adds two specially trained oncology nurse practitioners to help women with a history of cancer safely maintain sexual health through treatment and beyond.

Kristin E. Rojas, M.D., assistant professor of surgical oncology in the DeWitt Daughtry Department of Surgery and Sylvester Comprehensive Cancer Center at the University Miami Miller School of Medicine, realized she struck a chord with women being treated for cancer when she started the Menopause Urogenital Sexual Health and Intimacy Clinic (MUSIC) in 2020.

An unexpectedly high demand for the MUSIC program among women concerned by vaginal dryness, painful sex, low sexual desire and more, challenged Dr. Rojas and colleagues to expand, soon after the clinic doors opened its doors at Sylvester. Two specially trained oncology nurse practitioners were added to help women with a history of cancer safely maintain sexual health through treatment and beyond.

“MUSIC adds to the comprehensive aspect of survivorship care at Sylvester, making sure that we not only address side effects that we talk about all the time, like hot flashes, joint pain, fatigue, etc., but also the more taboo topics that aren’t always brought up,” Dr. Rojas said. Referrals to the program include women who are undergoing treatments that trigger menopause or worsen menopausal symptoms. They might silently suffer from symptoms related to genitourinary complaints, such as vaginal dryness, painful sex or from a global sexual functioning aspect, such as depressed libido.

“One might think that these symptoms only impact gynecologic or breast cancer patients who get estrogen-blocking medication, but it’s also women with other cancer types. In fact, anyone who gets chemotherapy can experience these issues,” she said. “Women who have large abdominal surgery, like a radical hysterectomy or a colectomy, could have sexual function concerns. Anyone who has had their ovaries removed, as well as women who haven’t had surgery or chemotherapy but are coping with the psychologic aspects of the diagnosis— that, too, can influence aspects of intimacy.”

The MUSIC program is one of only a few women’s sexual health programs at cancer centers in the U.S., and it serves as a research center for new treatments aimed at addressing women’s sexual health concerns in the setting of cancer. Care guidelines for prostate and other cancers include the importance of addressing the potential impact of cancer treatment on men’s sexual health.

“Oftentimes, men are given options for treatment based on how treatments will impact their sexual health,” Dr. Rojas said. “We’re demonstrating this also is an important option for women undergoing cancer treatment, not only from an equity standpoint but also to make sure these resources are effective and safe for women with cancer. For a long time, we didn’t have solutions for these patients, but that’s changing. It’s important to steer our patients to providers like ours who are oncology clinicians experienced in treating sexual health concerns.”