Background: Gynaecological cancer impacts approximately three million women globally. The problem is much more intense in resource-limited countries. Sexual health is a critical aspect of gynaecological cancer treatment and an important component of quality of life (QoL).

Aims: This study aimed to assess the determinants of sexual function among survivors of gynaecological cancer.

Method: This was a cross-sectional study. The simple random sampling technique was used to recruit survivors of gynaecological cancers aged 18 years and above on follow-up in a tertiary hospital in Kenya.

Tools: The study used the socio-demographic survey, Body Image Scale, Multidimensional Perceived Social Support Scale and Female Sexual Function Index.

Results: Cervical cancer was the most common gynaecological malignancy among respondents (51%). The mean total score of the Female Sexual Function Index was significantly low at 10.0 (cut off = 26.5). The majority (85%) of respondents had sexual dysfunction. The most commonly affected sexual domain was lubrication at a mean value of 0.91 (SD = 1.58). Age (aOR = 0.05, 95% CI: 0.003–0.16, p = 0.005), cancer stage 3 (aOR = 9.81, 95% CI: 1.34–20.56, p = 0.035) and social support (aOR = 1.29, 95% CI: 1.05–1.59, p = 0.015) were independent predictors of sexual dysfunction.

Conclusion: The prevalence of sexual dysfunction among gynaecological cancer survivors remains significantly high. Having cervical cancer was the most significant predictor of sexual dysfunction in this study population.