Purpose <p>Evidence regarding sexual health among patients with breast cancer undergoing endocrine therapy remains under-addressed in clinical practice. This review synthesised articles both in English and Chinese to explore the sexual health status and related factors in these patients.</p> Methods <p>An integrative review was conducted. Articles published from database inception to March 2025 were retrieved from CINAHL, Cochrane Library, China National Knowledge Infrastructure, PubMed, OVID, ScienceDirect, Web of Science, and Wiley Online Journals. Whittemore and Knafl’s five steps were followed, and the methodological quality was assessed using a mixed methods appraisal tool. Data were synthesised and compared to identify similarities and differences among articles.</p> Results <p>A total of 43 articles were selected from 3590 records for analysis: 39 quantitative, three qualitative, and one mixed methods study. Eleven articles reported sexual dysfunction prevalence between 51 and 93%, whereas only one article indicated a rate of 29%. Thirteen articles reported various symptoms of genitourinary syndrome of menopause while vaginal dryness and dyspareunia were consistently the main complaints. Age, financial burden, partnerships, physical and psychological status, and treatment factors were associated with women’s sexual health. A “silence gap” in sexual health care was identified, with many healthcare professionals failing to address it.</p> Conclusion <p>Patients undergoing endocrine therapy experience a high prevalence of sexual dysfunction and symptoms of genitourinary syndrome of menopause. Several factors affect women’s sexual health, including sociodemographic, physical, psychological, and treatment factors. A comprehensive assessment and targeted support should be offered to enhance sexual health outcomes in this population.</p>