Abstract
PurposeSexual health is a key quality of life issue. Knowledge concerning sexual health in long-term breast cancer survivors (BCSs) is limited. Within a nationwide sample, we aimed to assess the prevalence of sexual inactivity and to explore factors associated with sexual inactivity and reduced sexual functioning among long-term BCSs.MethodsLong-term BCSs aged 20–65 years when diagnosed with early-stage breast cancer in 2011–2012 were identified by the Cancer Registry of Norway in 2019 (n = 2803) and invited to participate in a nationwide survey. Sexual health was measured using the multidimensional Sexual Activity Questionnaire. Factors associated with sexual inactivity and reduced sexual functioning were explored using multivariable logistic- and linear regression analyses with adjustments for relevant sociodemographic, health-, and cancer-related variables.ResultsThe final sample consisted of 1307 BCSs with a mean age of 52 years at diagnosis. Fifty-two percent of the BCSs were sexually inactive. Lack of interest was the most common reason for sexual inactivity. Treatment with aromatase inhibitor (OR 1.73, 95% CI 1.23, 2.43) and poor body image (OR 0.99, 95% CI 0.99, 0.995) were associated with sexual inactivity. Among sexually active BCSs, depression (B − 1.04, 95% CI − 2.10, − 0.02) and physical inactivity (B − 0.61, 95% CI − 1.21, − 0.02) were inversely related to sexual pleasure. Treatment with aromatase inhibitor (B 0.61, 95% CI 0.20, 1.01), sleep problems (B 0.37, 95% CI 0.04, 0.70), breast symptoms (B 0.01, 95% CI 0.003, 0.02), and chronic fatigue (B 0.43, 95% CI 0.05, 0.81) were associated with sexual discomfort. Chemotherapy (OR 1.91, 95% CI 1.23, 2.97), current endocrine treatment (OR 1.98, 95% CI 1.21, 3.25), and poor body image (OR 0.98, 95% CI 0.98, 0.99) were associated with less sexual activity at present compared to before breast cancer.ConclusionTreatment with aromatase inhibitor seems to affect sexual health even beyond discontinuation. Several common late effects were associated with sexual inactivity and reduced sexual functioning. To identify BCSs at risk of sexual dysfunction, special attention should be paid to patients treated with aromatase inhibitor or suffering from these late effects.
Highlights
Due to advances in diagnostics and treatment, the five-year relative survival rate for early-stage breast cancer (BC) has surpassed 90% in the Western world [1, 2]
In the post-treatment phase, many breast cancer survivors (BCSs) struggle with late effects, such as chronic fatigue (CF) and persistent mental distress [12], which may affect their sexual health in a negative way
Most participants lived with a partner (74%) and had been treated for BC stage I or II (81%) with breast-conserving therapy (59%), radiotherapy (80%), endocrine therapy (65%), and chemotherapy (69%)
Summary
Due to advances in diagnostics and treatment, the five-year relative survival rate for early-stage breast cancer (BC) has surpassed 90% in the Western world [1, 2]. The number of long-term breast cancer survivors (BCSs) (i.e., more than five years since diagnosis) is steadily increasing, and research concerning different aspects of survivorship care is of considerable interest. Sexual health, defined as a state of physical, emotional, mental, and social well-being in relation to sexuality [3], is an important aspect of quality of life [4, 5]. Female sexual dysfunction includes lack of sexual interest and arousal,. BCSs face challenges related to BC treatment and to late effects of different treatment modalities that may further negatively affect their sexual health. BC treatment is often intensive, including combinations of surgery, radiotherapy, and systemic therapies. In the post-treatment phase, many BCSs struggle with late effects, such as chronic fatigue (CF) and persistent mental distress [12], which may affect their sexual health in a negative way. BCSs represent a vulnerable group with regards to impaired sexual health
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
