Menopausal Status in Breast Cancer Patients with Past Chemotherapy Determines Long-Term Hypoactive Sexual Desire Disorder

Abstract

Chemotherapy and endocrine treatment in young breast cancer patients are frequently associated with abrupt menopause. Little is known about the long-term prevalence of hypoactive sexual desire disorder (HSDD) in these patients. To examine the effects of adjuvant endocrine therapy on sexual desire in premenopausal patients with breast cancer and past chemotherapy. A controlled, cross-sectional study enrolled 47 women with breast cancer or benign breast disease at a tertiary care center. A standardized questionnaire (Sexual Interest and Desire Inventory-Female; SIDI-F) on HSDD was utilized. Serum concentrations for estradiol were measured by a specific assay. The SIDI-F interview was applied in 35 women with breast cancer (mean age: 42.3 years) with eventual adjuvant endocrine therapy, 2-8 years after chemotherapy, and 13 women with benign breast tumors (mean age: 39.8 years), 2-5 years after diagnosis. Mean SIDI-F scores were similar in the breast cancer group (32.9) and the benign breast disease group (34.0). Subgroup analysis revealed no statistical differences in the mean SIDI-F scores with respect to the actual endocrine therapy. However, in breast cancer patients with menopause induced by chemotherapy or gonadotropin-releasing hormone (GnRH) agonists, the SIDI-F scores were significantly lower (30.7) compared to breast cancer patients with menorrhea (40.4). In breast cancer patients, amenorrhea was associated with significantly lower estradiol levels compared to menorrhea (24 pg/mL vs. 91 pg/mL; P = 0.02). Cancer treatment that leads to long-term ovarian failure in breast cancer patients has a negative impact on sexual desire. Patients with menopause induced by chemotherapy or GnRH agonists show significantly reduced sexual desire as compared to menstruating patients with past chemotherapy.