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Sexual Problems in Younger Women After Breast Cancer Surgery

Stephanie R. Burwell, L. Douglas Case, Carolyn Kaelin, Nancy E. Avis

From the University of Georgia, Department of Child and Family Development, Athens, GA; Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC; and the Comprehensive Breast Health Center, Brigham and Women's Hospital, Boston, MA

Address reprint requests to Nancy E. Avis, PhD, Department of Public Health Sciences, Section on Social Sciences and Health Policy, Wake Forest University School of Medicine, Piedmont Plaza II, 2000 W First St, Winston-Salem, NC 27157-1063; e-mail: navis{at}wfubmc.edu

PURPOSE: To examine sexual problems in younger women diagnosed with breast cancer during the first year after surgery and to identify sociodemographic, medical, and psychosocial predictors of sexual problems.

PATIENTS AND METHODS: Women diagnosed with breast cancer age 50 years completed surveys at three time points: within 24 weeks after initial surgery (baseline), 6 weeks after baseline, and 6 months later. Survey items included the Medical Outcomes Study Sexual Functioning Scale, satisfaction with sex life, feeling sexually attractive, body image, marital satisfaction, quality of life, medical history, symptoms, and sociodemographics. Prediagnosis sexual problems were retrospectively ascertained at the initial survey.

RESULTS: Analyses included 209 women sexually active at baseline (78.6% of total sample). Sexual problems were significantly greater immediately postsurgery compared with retrospective reports before diagnosis (P < .0001). Although problems gradually decreased over time, they were still greater at 1 year postsurgery than before diagnosis. In multivariate analyses controlling for sexual problems at prediagnosis, vaginal dryness, and lower perceived sexual attractiveness were consistently related to greater overall sexual problems. Chemotherapy was related to sexual problems only at baseline except for women who became menopausal as a result of chemotherapy, who continued to have problems.

CONCLUSION: Findings substantiate the need to address potential sexual problems related to chemotherapy treatment and menopause among younger breast cancer survivors and to counsel women about possible remedies, particularly for vaginal dryness. Increasing feelings of sexual attractiveness may also help sexual problems, especially among women for whom these feelings were altered by surgery or treatment.

Supported by Grant No. R01CA64716 from the National Cancer Institute.

Presented in poster format at the American Psychosocial Oncology Society meeting in Orlando, FL, January 29-February 1, 2004.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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