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Prospective Association of Psychological Distress and Sexual Quality of Life Among Hematopoietic Stem Cell Transplant Survivors

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Abstract

Sexual health concerns are one of the most common late effects facing hematopoietic stem cell transplant (HSCT) survivors. The current study tested whether self-reported depression and anxiety symptoms before transplant were associated with embedded items assessing two specific areas of sexual health—sexual interest and sexual satisfaction—one year post-HSCT. Of the 158 study participants, 41% were diagnosed with a plasma cell disorder (n = 60) and most received autologous transplantation (n = 128; 81%). At post-HSCT, 21% of participants reported they were not at all satisfied with their sex life, and 22% were not at all interested in sex. Greater pre-HSCT depressive symptomology was significantly predictive of lower sexual interest (β = −.27, p < .001) and satisfaction (β = −.39, p < .001) at post-HSCT. Similarly, greater pre-HSCT trait anxiety was significantly predictive of lower sexual interest (β = −.19, p = .02) whereas higher levels of state and trait anxiety were both predictive of lower satisfaction (β = −.22, p = .02 and β = −.29, p = .001, respectively). Participant sex significantly moderated the relationship between state anxiety and sexual satisfaction (b = −.05, t = −2.03, p = .04). Additional research examining the factors that contribute to sexual health post-HCST is needed to inform and implement clinical interventions to address these commonly overlooked survivorship concerns.

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Data may be available upon request to the corresponding author.

Notes

  1. Of note, these are presumed to be cisgender samples. Cisgender men are individuals who were assigned male sex at birth and identify as men, whereas cisgender women were assigned female sex at birth and identify their gender as women. We have elected to retain language used by the original publications being cited, while recognizing that many such studies do not actually assess gender, rather infer gender based on sex assigned at birth. The inappropriate conflation of anatomical sex and gender is a major limitation of the existing literature and state of the science. Johnson and colleagues provide an excellent discussion of this longstanding barrier in health-focused research.17 (Johnson, Greaves, & Repta, 2009).

  2. Relevant professional organizations include: the American Association of Sexuality Educators, Counselors and Therapists (AASECT), The International Society for Sexual Medicine (ISSM), The International Society for the Study of Women's Sexual Health (ISSWSH), and The Scientific Network on Female Sexual Health and Cancer.

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Funding

This work was made possible by Grant KL2 RR 02415 (PI: Ehlers), CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH).

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Authors and Affiliations

  1. Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA

    Jennifer A. Vencill, Janae L. Kirsch, Keagan McPherson, Christi A. Patten, Tabetha Brockman, Carrie Bronars, Christine Hughes, Dennis Gastineau & Shawna L. Ehlers

  2. Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Jennifer A. Vencill

  3. Minnesota State University, Mankato, MN, USA

    Keagan McPherson, Eric Sprankle & Kristie Campana

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  1. Jennifer A. Vencill
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Contributions

SE, CP, and DG designed the study. SE, TB, and CH contributed to the acquisition of data. JK and KM analyzed the data. JV, JK, SE, KM, CP, ES, and KC interpreted the data. JV, JK, SE, and KM drafted the manuscript. All authors critically revised the manuscript. All authors have read the manuscript and have agreed with its submission.

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Correspondence to Shawna L. Ehlers.

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Conflict of interests

Jennifer A. Vencill, Janae L. Kirsch, Keagan McPherson, Eric Sprankle, Christi A. Patten, Kristie Campana, Tabetha Brockman, Carrie Bronars, Christine Hughes, Dennis Gastineau, and Shawna L. Ehlers have no conflicts of interest to report.

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This study was conducted in accordance with institutional review board policies and all participants provided informed consent (IRB: 08-006915).

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Vencill, J.A., Kirsch, J.L., McPherson, K. et al. Prospective Association of Psychological Distress and Sexual Quality of Life Among Hematopoietic Stem Cell Transplant Survivors. J Clin Psychol Med Settings (2024). https://doi.org/10.1007/s10880-024-10013-9

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