The majority of Danish breast cancer survivors on adjuvant endocrine therapy have clinically relevant sexual dysfunction: a cross-sectional study

Abstract

Background: Impairments in sexual function are common among breast cancer survivors (BCSs), particularly in BCSs receiving adjuvant endocrine therapy (AET). Whether these impairments cause distress, thus qualifying for a more clinically relevant diagnosis of sexual dysfunction (SD), is inadequately described among BCSs and represents an important research gap. Hence, the primary aim of this study was to estimate the prevalence of clinically relevant SD, in this context: impairments with associated distress, and to identify factors associated with SD among BCSs on AET. Secondly, to explore the extent of distress caused by specific impairments in sexual function. Materials and methods: In this cross-sectional study of BCSs on adjuvant treatment with endocrine therapy for at least three months, participants completed an online survey comprising standardized measures of sexual and psychosocial function. Female Sexual Function Index (FSFI) and Sexual Complaint Screener -Women (SCS-W) were used to asses clinically relevant SD. Multiple regression analyses were performed to identify factors significantly associated with SD. Results: In total, 333 BCSs with a mean age of 58.7 years were included in the study, of whom 227 were sexually active. Among sexually active BCSs, 134 (59%) met the criteria for having clinically relevant SD, of whom 78 (58%) perceived cancer treatment as the primary reason for their sexual problems. Factors associated with SD included vaginal dryness (adjusted OR¼ 2.25, 95% CI: 1.52-3.34, p < .01) and psychological well-being (adjusted OR¼ 1.11, 95% CI: 1.03-1.18, p < .01). Age was not related to neither prevalence of SD nor the level of distress caused by any impairment, with exception of low sexual desire. Pain in relation to intercourse was the most distressing impairment. Conclusion: SD was highly prevalent among sexually active BCSs on AET. Sexual health is important to address independent of the woman's age.

Gynecologic Symptoms among Hormone Receptor-Positive Breast Cancer Patients on Oral Endocrine Therapy: A Cross-Sectional Study

“…FSD, as classified by the FSFI, was identified in 61.2% of the sexually active patients within our study sample. A cross-sectional study which similarly applied the FSFI solely in sexually active breast cancer patients on ET and used the cut-off score of ≤26.55 reported FSD in 63% (142/227) of their study sample [32]. When comparing FSFI domain scores by ET type, we observed no significant differences, which is inconsistent with previous observational studies evaluating the symptoms covered by these domains [16].…”

Sexual health in long-term breast cancer survivors: a comparison with female population controls from the HUNT study

“…Treatment for stage I–III BC is often intense including combinations of surgery, radiotherapy, and adjuvant systemic therapies (endocrine therapy, chemotherapy, and targeted therapy), which may have a negative impact on sexual health [ 8 – 10 ]. Studies have focused on various aspects of sexual health, like sexual activity, interest, enjoyment and discomfort, and reported that sexual health impairments are prevalent among BCSs both during treatment and during the first years after diagnosis [ 11 – 15 ]. However, it remains unclear if these sexual health impairments persist long-term (> 5 years after diagnosis), as data from this part of survivorship are scarce and results conflicting [ 16 – 19 ].…”

Sexual activity and functioning in long-term breast cancer survivors; exploring associated factors in a nationwide survey

“…Prevalence estimates differ, however, widely across studies from 27% [14] to 93% [15], primarily reflecting methodological differences. Most studies focus on sexual health during the first few years after BC diagnosis [15][16][17][18][19] and therefore research-based knowledge concerning sexual health among long-term BCSs is limited [20][21][22][23][24]. Furthermore, how different BC treatments (surgery, chemotherapy, and endocrine therapy) contribute to sexual dysfunction at long term is still unclear [5,[24][25][26][27][28].…”