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Sexual Dysfunction in Survivorship; the Impact of Menopause and Endocrine Therapy

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Sexual dysfunction is common for breast cancer survivors. Premenopausal women with breast cancer are increasingly offered ovarian suppression and aromatase inhibitor (AI) therapy. We evaluated the association of menopausal status and treatment modalities on sexual dysfunction.

Methods

We conducted a cross-sectional anonymous Female Sexual Function Index (FSFI) survey of breast cancer survivors between 2000 and 2016. Analysis utilized Kruskal–Wallis test for FSFI scores, Chi square, or Fisher’s exact test for categorical data, and regression analysis for associations.

Results

Of 585 respondents, 278 (47.5%) had complete FSFI scores. Of these, 24 (8.6%) were premenopausal and 80 (28.8%) were pre/perimenopausal at survey completion. Median FSFI scores for premenopausal (31.2, interquartile range [IQR] 26.8–33.6) and pre/perimenopausal (29.2, IQR 25.9–32.2) were similar, whereas postmenopausal women (25.9, IQR 21.0–30.3) were significantly lower (p = 0.0007 and p = 0.0002, respectively). Premenopausal women were less likely to meet criteria for sexual dysfunction (FSFI score ≤ 26.55) than postmenopausal women (21 versus 55%, p < 0.0001, univariate analysis [odds ratio (OR) 0.32, 95% confidence interval (CI) 0.18–0.56]). Adjusting for treatment modality did not impact the significance (OR 0.43, 95% [CI] 0.23–0.80) but revealed that AIs independently are associated with sexual dysfunction (OR 2.41, 95% CI 1.32–4.40). The interaction between menopausal status and AIs was not significant (p = 0.24).

Conclusions

Our study demonstrates that menopausal status is associated with sexual dysfunction in breast cancer patients and sexual dysfunction in premenopausal women is not impacted by treatment modality outside of aromatase inhibitor therapy. As more premenopausal patients are treated with ovarian suppression, these data may guide clinicians in counseling patients regarding sexual dysfunction expectations.

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Authors and Affiliations

  1. Breast Health Center, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA

    Reed Kuehn MD, Jesse Casaubon DO, David Edmonson MD, Ashley Stuckey MD & Jennifer Gass MD

  2. Division of Research, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA

    Christina Raker ScD

  3. Department of Surgery, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA

    David Edmonson MD & Jennifer Gass MD

  4. Gynecologic Oncology, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA

    Ashley Stuckey MD

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  1. Reed Kuehn MD
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  2. Jesse Casaubon DO
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Correspondence to Reed Kuehn MD.

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Kuehn, R., Casaubon, J., Raker, C. et al. Sexual Dysfunction in Survivorship; the Impact of Menopause and Endocrine Therapy. Ann Surg Oncol 26, 3159–3165 (2019). https://doi.org/10.1245/s10434-019-07552-z

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