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The relationship between anxiety and vaginal-related sexual health in postmenopausal breast cancer survivors on aromatase inhibitors therapies: a cross sectional study

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Sexual health problems and anxiety are disruptive symptoms in breast cancer survivors; however, little is known about these symptoms in postmenopausal breast cancer survivors on aromatase inhibitors therapies. This study aimed to determine the relationship between anxiety and vaginal-related sexual health problems in this population.

Methods

We analyzed cross-sectional data from a cohort study of postmenopausal women breast cancer survivors receiving aromatase inhibitors. Vaginal-related sexual health problems were assessed with the Breast Cancer Prevention Trial Symptom Checklist. Anxiety was assessed with the anxiety subscale of the Hospital Anxiety and Depression Scale. We used multivariable logistic regression to evaluate relationship between anxiety and vaginal-related sexual health adjusted for clinical and sociodemographic variables.

Results

Among 974 patients, 305 (31.3%) reported anxiety and 403 (41.4%) had vaginal-related sexual health problems. Compared to those without anxiety, patients with borderline and clinically abnormal anxiety reported higher rates of vaginal-related sexual health problems (36.8% vs. 49% and 55.7% respectively, p < 0.001). In multivariate analyses adjusted for clinical and sociodemographic factors, abnormal anxiety was associated with a higher rate of vaginal-related sexual health problems, with adjusted odds ratios of 1.69 (95% CI 1.06–2.70, p = 0.03). Vaginal-related sexual health problems were more frequent among patients who were under 65 years of age, received Taxane-based chemotherapy, reported depression, and were married/living with a partner (p < 0.05).

Conclusion

Among postmenopausal breast cancer survivors on aromatase inhibitors therapies, anxiety was significantly associated with vaginal-related sexual health problems. As treatments for sexual health problems are limited, results suggest that psychosocial interventions for anxiety could potentially be adapted to simultaneously address sexual health needs.

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Data availability

The data of this study will be available from the corresponding author upon reasonable request.

Abbreviations

ACC:

Abramson Cancer Center

AI:

Aromatase inhibitor

AOR:

Adjusted odds ratio

BCPT:

Breast Cancer Prevention Trial Symptom Checklist

BMI:

Body mass index

95% CI:

95% Confidence interval

HADS:

Hospital Anxiety and Depression Scale

WABC:

Wellness After Breast Cancer

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Funding

This work was supported in part by a National Institutes of Health/National Cancer Institute (NCI) R01CA158243 (PI: Mao), NCI R01 CA240417 (PI: Mao), and NCI Cancer Center grant (P30 CA008748).

Author information

Authors and Affiliations

  1. Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Karolina Bryl, Xiaotong Li, Susan Q. Li & Jun J. Mao

  2. Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Susan Chimonas

  3. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Susan Chimonas

Authors
  1. Karolina Bryl
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  2. Susan Chimonas
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  3. Xiaotong Li
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  4. Susan Q. Li
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  5. Jun J. Mao
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Contributions

Conceptualization: JJM and KB. Methodology: JJM and KB. Formal analysis: SQL. Writing—original draft: KB. Writing—review and editing: KB, SC, XTL, and JJM. Supervision: JJM.

Corresponding author

Correspondence to Jun J. Mao.

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Conflict of interest

The authors declare the following financial relationships: JJM reports grants received on behalf of Memorial Sloan Kettering Cancer Center from Tibet CheeZheng Tibetan Medicine Co. Ltd. and from Zhongke Health International LLC outside the submitted work. Other authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This research was reviewed and approved by the Institutional Review Board of the University of Pennsylvania and the ACC Clinical Trials Scientific Review and Monitoring Committee.

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Informed consent was obtained from all individual participants included in the study.

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Bryl, K., Chimonas, S., Li, X. et al. The relationship between anxiety and vaginal-related sexual health in postmenopausal breast cancer survivors on aromatase inhibitors therapies: a cross sectional study. Breast Cancer Res Treat 200, 257–264 (2023). https://doi.org/10.1007/s10549-023-06981-5

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