Evaluation of sexual dysfunction in gynecologic cancer survivors using DSM-5 diagnostic criteria

Hao Lin,Yi-Jen Tsai,Yu-Che Ou,Chen-Hsuan Wu,Hung-Chun Fu,Yin-Jou Chou,Chun-Ming Shih

doi:10.1186/s12905-021-01559-z

Abstract

BackgroundIn gynecologic cancer survivors, female sexual dysfunction (FSD) remains under-investigated. We attempted to estimate the prevalence of FSD associated with distress in gynecologic cancer survivors using diagnostic and statistical manual of mental disorders fifth edition (DSM-5) diagnostic criteria and to identify women at risk for FSD.MethodsWe conducted a cross-sectional analysis of premenopausal women aged 20–50 with various gynecologic cancers at least one year after treatment between January 2017 and December 2019. Data of sociodemographics and physical conditions were collected via face-to-face interview during outpatient clinic visits. The domains we used to define FSD were based on DSM-5 diagnostic criteria. Statistical analysis was carried out using Student's t test, Chi-square test and multiple logistic regression.ResultsA total of 126 gynecologic cancer survivors with a mean age of 42.4 years were included for analysis and 55 of them (43.7%) were diagnosed as having FSD associated with distress based on DSM-5 criteria. More than half of women (65.1%) reported decreased sexual satisfaction after cancer treatment. According to DSM-5 definition, the most common female sexual disorders were sexual interest/arousal disorder (70.9%), followed by genitopelvic pain/penetration disorder (60.0%), and orgasmic disorder (20.0%). In multiple logistic regression model, endometrial cancer diagnosis was the only independent factor predicting less influence of cancer treatment on FSD (OR 0.370; 95% CI 0.160, 0.856).ConclusionThe first study to use DSM-5 criteria for estimation of FSD prevalence. This enables clinicians to identify which women are actually needed to seek medical help. A prevalence of 43.7% of FSD associated with distress was found in a group of gynecologic cancer survivors with the most common being sexual interest/arousal disorder. Endometrial cancer survivors were at low risk for developing FSD after treatment.

Highlights

In gynecologic cancer survivors, female sexual dysfunction (FSD) remains under-investigated
Due to disease nature and location, gynecologic cancer survivors are at high risk of developing sexual dysfunction, infertility, and body image alteration owing to the treatment modality, treatment-related genital organ deformities, and hormonal changes
In present study, we are the first of using DSM-5 criteria to investigate FSD associated with distress and found a prevalence of 43.7% in a group of gynecologic cancer survivors with the most common problem being sexual interest/arousal disorder

Summary

Introduction

We attempted to estimate the prevalence of FSD associated with distress in gynecologic cancer survivors using diagnos‐ tic and statistical manual of mental disorders fifth edition (DSM-5) diagnostic criteria and to identify women at risk for FSD. Due to disease nature and location, gynecologic cancer survivors are at high risk of developing sexual dysfunction, infertility, and body image alteration owing to the treatment modality, treatment-related genital organ deformities, and hormonal changes. These may occur immediately following treatment and even during long-term follow up [4, 5]. Sexual health is still an under-researched area in gynecologic oncology and rarely discussed with care providers due to lack of knowledge

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Conclusion