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Objective. To assess the sexual health and interest of breast cancer survivors (BCSs) in a tailored evaluation of their sexuality. Methods. A descriptive analysis on baseline sexual assessment of female BCS with genitourinary syndrome of menopause (GSM) receiving aromatase inhibitors (AIs), who have participated on an ongoing double-blinded randomized controlled trial on the efficacy and safety of laser therapy (NCT04619485), was conducted. Epidemiological and BC variables, as well as mental, vaginal, and basic sexual health assessment (self-reported sexual activity and frequency, sexual behavior, type of sexual activity and relationship status, Female Sexual Function Index (FSFI), and Body Image Scale questionnaires and 2 visual analogue scales (VASs) about sexual life disturbance and dyspareunia) were recorded. An optional specialized sexual assessment was offered. Results. Among 83 participants, 67 (80.7%) wanted sexual counseling. Half of them had a body image alteration, and 74% worsened their sexual life after receiving BC diagnosis and treatments. The sexual activity rate was 71.1%. Sexually inactive women had higher impairment of FSFI desire dimension ( p = 0.0013 ), dyspareunia ( p = 0.0114 ), and unsatisfaction with their sexuality ( p = 0.0530 ) compared to sexually active women. In sexually active women, the mean FSFI and all of its dimensions showed a lower score. The most frequent sexual behavior was a combination of nonvaginal and vaginal sex, despite the high intensity of dyspareunia (mean VAS ± SD: 7.1 ± 2.1). Conclusion. Most of the BCSs with GSM receiving AI were interested in a specialized sexual consultation. Sexual activity and function were impaired, either secondary to dyspareunia or to other biopsychosocial sexual factors.
Objective. To assess the sexual health and interest of breast cancer survivors (BCSs) in a tailored evaluation of their sexuality. Methods. A descriptive analysis on baseline sexual assessment of female BCS with genitourinary syndrome of menopause (GSM) receiving aromatase inhibitors (AIs), who have participated on an ongoing double-blinded randomized controlled trial on the efficacy and safety of laser therapy (NCT04619485), was conducted. Epidemiological and BC variables, as well as mental, vaginal, and basic sexual health assessment (self-reported sexual activity and frequency, sexual behavior, type of sexual activity and relationship status, Female Sexual Function Index (FSFI), and Body Image Scale questionnaires and 2 visual analogue scales (VASs) about sexual life disturbance and dyspareunia) were recorded. An optional specialized sexual assessment was offered. Results. Among 83 participants, 67 (80.7%) wanted sexual counseling. Half of them had a body image alteration, and 74% worsened their sexual life after receiving BC diagnosis and treatments. The sexual activity rate was 71.1%. Sexually inactive women had higher impairment of FSFI desire dimension ( p = 0.0013 ), dyspareunia ( p = 0.0114 ), and unsatisfaction with their sexuality ( p = 0.0530 ) compared to sexually active women. In sexually active women, the mean FSFI and all of its dimensions showed a lower score. The most frequent sexual behavior was a combination of nonvaginal and vaginal sex, despite the high intensity of dyspareunia (mean VAS ± SD: 7.1 ± 2.1). Conclusion. Most of the BCSs with GSM receiving AI were interested in a specialized sexual consultation. Sexual activity and function were impaired, either secondary to dyspareunia or to other biopsychosocial sexual factors.
<b><i>Introduction:</i></b> The correlation between sex hormone levels and pelvic bone mineral density in people with urinary incontinence (UI) has not been evaluated. This study explored the association between sex hormones, pelvic bone mineral density, and UI, and analyzed the association between pelvic bone mineral density-combined sex hormones and UI in women. <b><i>Method:</i></b> The data of the National Health and Nutrition Examination Survey (NHANES) 2013–2014 were used in this cross-sectional study. Women aged 20 years and older with complete sex steroid hormone and pelvic bone mineral density data were included. Outcomes were stress UI (SUI), urgency UI (UUI), and mixed UI (MUI). Sex steroid hormone included testosterone, estradiol, and sex hormone binding globulin (SHBG). Multivariate logistic regression analyses with the odds ratios (ORs) and 95% confidence intervals (CIs) were used. <b><i>Results:</i></b> Of 2,442 women, 579 had SUI, 202 had UUI, and 344 had MUI. The estimated multiplicative interactions were significantly between testosterone and pelvic bone mineral density, between SHBG and pelvic bone mineral density on UI (<i>p</i> = 0.002, <i>p</i> = 0.003), MUI (<i>p</i> = 0.036, <i>p</i> < 0.001), and SUI (<i>p</i> = 0.008, <i>p</i> = 0.044), respectively. High pelvic bone mineral density was associated with UI (<i>p</i> = 0.022) and MUI (<i>p</i> = 0.028) in the age <45-year-old subgroup. Multiplicative interactions were between testosterone and pelvic bone mineral density on all types of UI in the age <45-year-old subgroup, on SUI in women who did not have vaginal deliveries, and on UI in women who had more than one-time vaginal delivery. <b><i>Conclusion:</i></b> Our study found negatively multiplicative interactions between testosterone, SHBG, and pelvic bone mineral density on UI, MUI, and SUI. Similar results were found in women aged <45 years old and in women who had more than one-time vaginal delivery. Clinicians may consider testosterone or SHBG supplementation and pelvic density enhancement in women with SUI, MUI, and low endogenous testosterone levels.
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