Chemotherapy Use Is a Significant Predictor for Sexual Dysfunction in Women with Gynecologic Cancer

Abstract

Objectives: Sexual dysfunction is a significant survivorship issue in women with gynecologic cancer. We examined the association between chemotherapy and impaired sexual functioning. Methods: A cross sectional study of women with gynecologic cancer was conducted with a 181-item survey of validated instruments. A sub-analysis of women with chemotherapy treatment was performed to examine factors associated with sexual function including age, menopause status, BMI, diagnosis, stage, surgery/radiation use, active disease status, number of regimens, and number of cycles. Sexual dysfunction was measured by change in the Female Sexual Function Index (FSFI) score from pre-treatment with a significant decline in sexual function determined to be a 5.6 point decrease using a Reliable Change Index Statistic (RCIS). Standard statistical tools were employed. Results: A total of 107 (63%) of the women in the larger study had received chemotherapy as part of their treatment and were included in the sub-study. Women undergoing chemotherapy were more likely to experience sexual dysfunction post-treatment (51% vs. 26%; OR 2.9, 95% CI 1.5 - 5.7). In bivariate analyses, sexual dysfunction following chemotherapy was associated with age < 50 (80% vs. 42%; OR 5.6, 95% CI 1.9 - 16.6), premenopausal (30.8% vs. 12.7%, OR 3.1, 95% CI 1.1 - 8.2) cervical cancer (25.5% vs. 10.0%, OR 3.1, 95% CI 1.0 - 9.4), and low (I/II) stage (51.1% vs. 24.5%; OR 3.2, 95% CI 1.4 - 7.7). Conclusions: Women treated with chemotherapy for gynecologic cancer are at a significant risk of impaired sexual function. Women with cervical cancer, early stage disease, those who are premenopausal, and those younger than age 50 are at the highest risk.