Sexual functioning in women with breast cancer after treatment with adjuvant therapy.
The purpose of this research was to describe current sexual functioning in women with breast cancer comparing women treated with chemotherapy or endocrine therapy to women treated without pharmacological manipulation. Sixty-seven women diagnosed with stage I, II, or III breast cancer responded to a two-part mailed questionnaire. The first part of the questionnaire asked about menopausal symptoms (weight changes, hot flashes, mood swings, and anxiety attacks) the women might currently be experiencing and about various symptoms that might be currently interfering with sexual functioning (vaginal dryness, decreased libido, dyspareunia, and difficulty achieving orgasm). The second part of the questionnaire was the Derogatis Sexual Functioning Inventory (DSFI) designed to measure current sexual functioning in ten areas. The women who participated in this study were primarily middle class, white, and married. Controlling for endocrine therapy, the 25 women treated with chemotherapy were 6.5 times more likely than women not treated with chemotherapy to report weight changes (p = 0.001), 3.6 times more likely to report hot flashes (p = 0.02), and 6.5 times more likely to report mood swings (p = 0.001). Additionally, still controlling for endocrine therapy, the women treated with chemotherapy were 5.7 times more likely than women not treated with chemotherapy to report vaginal dryness (p = 0.001), 3.0 times more likely to report decreased libido (p = 0.04), 5.5 times more likely to report dyspareunia (p = 0.003), and 7.1 times more likely to report difficulty achieving orgasm (p = 0.004). Controlling for chemotherapy, the 20 women treated with endocrine therapy did not experience either menopausal or sexual dysfunction symptoms significantly differently from women not treated with endocrine therapy. Controlling for endocrine therapy, there was a significant negative effect of chemotherapy on body image (p = 0.01), affects (p = 0.001), psychological symptoms (p = 0.001), and overall sexual functioning (p = 0.02). However, controlling for chemotherapy, there was no significant effect of endocrine therapy on any of the DSFI subscales. This study indicates that women who have received chemotherapy are especially susceptible to adverse changes in their current sexual functioning.