Sexual Activity Questionnaire Research Articles

Changes in sexuality during ulipristal acetate treatment in women with symptomatic uterine fibroids

ObjectiveTo evaluate changes in sexuality in women treated with Ulipristal acetate (UPA) due to symptomatic uterine fibroids. Study designA total of 102 women with symptomatic uterine fibroids undergoing conservative therapy with UPA were enrolled in this observational study. Sexuality was evaluated before and after a three month UPA treatment using the Female Sexual Functioning Index (FSFI) as well as the Sexual Activity Questionnaire (SAQ). Before treatment was initiated, participants additionally filled in a standardised questionnaire addressing the expected changes in sexuality due to UPA. Demographic parameters, expectations concerning changes in sexuality, and FSFI- and SAQ-scores were analysed. ResultsThe average age of the study collective was 42.3 years. For the majority of the included women (n = 70; 71.4%) sexuality was rated as an important issue and 86 women (87.8%) did not think that UPA would have an impact on the frequency of sexual intercourse, the quality (n = 91; 92.9%) or frequency of orgasms (n = 87; 88.8%) neither sexual receptivity (n = 88; 89.8%). Full data sets were available for 73 patients (71.6%). The FSFI showed significantly higher sub scores regarding desire (3.6 ± 1.2 vs. 3.9 ± 1.2; p = 0.0012) and arousal (4.2 ± 1.7 vs. 4.4 ± 1.9; p = 0.0151) as well as a higher total score (26.6 ± 9.0 vs. 27.4 ± 9.5; p = 0.0008) after UPA treatment. Regarding the SAQ a statistically significant difference regarding the subscore “habit” was found (p < 0.0001) comparing pre with post interventional scores. ConclusionSexuality in general seems to be important for women with symptomatic uterine fibroids. As the treatment with UPA appears to improve sexuality, this circumstance can be mentioned in a pre-therapeutic counselling.

019 Evaluation of Patient-report Outcomes (PROs), Medical and Patient Characteristics of Colorectal/Anal Cancer Patients/Survivors

To evaluate patient-reported outcomes (PROs) and medical and patient characteristics of colorectal/anal cancer patients/survivors at the Female Sexual Medicine & Women’s Health Program (FSMWHP) at Memorial Sloan Kettering Cancer Center. A limited waiver of authorization was obtained for this retrospective study. Ninety-nine women with a history of colon, rectal or anal cancer were seen for an initial consult at the FSMWHP from 01/12–07/17. Data were collected using the FSMWHP Clinic Assessment Form, which includes the Vaginal Assessment Scale (VAS), Vulvar Assessment Scale (VuAS), vulvovaginal/sexual health promotion strategies, pelvic exam checklist, PROs (Female Sexual Function Index [FSFI] and Sexual Activity Questionnaire [SAQ]), and exploratory items. Descriptive statistics for our data analysis were calculated using SPSS. The sample consisted of patients with colon (n=9), rectal (n=49), or anal cancer (n=41) diagnosed between 1989-2015. Mean age was 48 years (range, 18-77). On average, patients were seen 3 years from diagnosis (range, 9 months–9.5 years). Sixty-seven percent (56/83) had mild-severe vaginal dryness; 36% (30/84) mild-severe dyspareunia (VAS); and 60% (44/73) mild-severe vulvar dryness (VuAS). On exam, 54% (30/56) had mild-severe vaginal atrophy. Forty percent (21/54) had fecal incontinence; 47%(27/58) urinary incontinence; 56% (32/57) currently used pads; and 67% (44/66) had pain with exam. Thirty-three percent reported current sexual activity. The primary reason for not engaging in sexual activity (SAQ) was a physical issue making sex difficult or uncomfortable (54%). In all, 98% (88/90) scored <26.6 on the FSFI (mean, 10.5; median, 8.0), indicating female sexual dysfunction; 48% (39/82) were not confident about future sexual activity.

Hormone Levels and Sexual Functioning After Risk-Reducing Salpingo-Oophorectomy

IntroductionWomen after risk-reducing salpingo-oophorectomy (RRSO) can have impaired sexual functioning, but whether there is an association between hormone levels and sexual functioning is unclear.AimTo determine whether hormone levels are associated with sexual functioning in women after RRSO.MethodsThis is a retrospective cohort study of 198 sexually active and 91 inactive women after RRSO. Participants completed the Sexual Activity Questionnaire, questionnaires concerning hormone replacement therapy (HRT), quality of life, care from partner, body image, and comorbidity and provided blood samples. Associations between sexual functioning scores and covariates were examined by linear regression. Variables associated with sexual activity were examined by logistic regression.Main Outcome MeasuresAssociations with sexual pleasure and sexual discomfort scores were expressed by multivariable regression coefficients and associations with sexual activity were expressed by odds ratios.ResultsNone of the hormone levels were associated with sexual pleasure in contrast to age (P = .032), current use of systemic HRT (P = .002), and more care form partner (P < .001). Increased free androgen index (P = .016), more care from partner (P = .017), systemic HRT (P = .002), and no history of cardiovascular disease (P = .001) were associated with less sexual discomfort. The odds ratio of being sexually active increased with younger age, no breast cancer, better quality of life, and more care from partner.ConclusionsOur results indicate that other factors than hormone levels are important for sexual functioning, although systemic HRT can have a positive impact on sexual functioning in women who have undergone RRSO. Testosterone therapy could improve women's sexual functioning after RRSO; however, the inverse association between free androgen levels and sexual discomfort should be addressed in future studies.Johansen N, Liavaag AH, Mørkird L, Michelsen TM. Hormone Levels and Sexual Functioning After Risk-Reducing Salpingo-Oophorectomy. Sex Med 2018;6:143–153.

Urinary incontinence and sexual health in a population sample of older people.

ObjectivesTo investigate the association between self‐reported urinary incontinence (UI) and sexual health in a representative sample of older people.Subjects and MethodsParticipants were community‐dwelling women and men aged 50–90+ years from the English Longitudinal Study of Ageing (ELSA) who reported any sexual activity in the last year. The prevalence of UI was assessed both cross‐sectionally (ELSA Wave 6; 2012) and retrospectively over the preceding 8 years (ELSA Waves 2–6; 2004–2012). Sexual activities, difficulties and concerns were assessed using a validated Sexual Relationships and Activities Questionnaire. The association between UI and sexual health outcomes was examined using weighted logistic regressions, with adjustments made for demographic, health, and lifestyle factors.ResultsAt Wave 6, 391 (20.0%) women and 141 (6.9%) men reported ‘any UI’ in the last 12 months. Compared to those without UI, women with UI reported declines in sexual activity and arousal over the last year, and increased concern about their frequency of sexual activity and ability to become sexually aroused. Men with ‘any UI’ reported declines in sexual desire, increased erectile and orgasm difficulties, and were more concerned about these sexual functions compared to men without UI. Differences in the patterns of association with sexual health were seen, dependent upon whether UI was reported as sporadic or persistent, and also with respect to the duration of retrospectively reported UI.ConclusionSelf‐reported UI was associated with impairment in sexual health in women and men, and mainly linked to recent declines in sexual activity and function along with elevated sexual concerns. Our findings highlight that the sexual health of older people should be considered when managing UI.

Abstract P6-12-22: Sexual health in long-term breast cancer survivors

Abstract Background Significant sexual dysfunction is reported in women with breast cancer (BC) in the years following diagnosis. It is unclear whether symptoms persist over time in BC survivors (BCS) as long-term data compared to healthy controls is lacking. We compared sexual functioning in long-term BCS to controls and explored the impact of adjuvant therapy on sexual health. Methods A cohort of women with localized BC recruited from 1989 to 1996 was prospectively followed as previously described. BCS without recurrence and controls without BC were contacted between 2005 and 2007 and answered self-reported quality of life questionnaires. Sexual health was measured with the Sexual Activity Questionnaire (SAQ). Vasomotor, gynecological and bladder symptoms were scored using the Menopausal Symptom Scale (scale ranges 0-4) based on the Breast Cancer Prevention Trial Symptom Checklist. Regression analysis was used to compare groups, with and without adjustment for age (quadratic) and menopausal status. P values &amp;lt;0.05 were considered significant. Results 248 of 285 BCS and 159 of 167 controls completed the SAQ. The median time from diagnosis of BCS was 12.5 years. BCS were slightly older (61.9 vs 59.1 years, p=0.0004) and somewhat more likely to be post-menopausal (94.4 vs 85.5%, p=0.0025) than controls. Overall, fewer BCS were sexually active than controls (45.2 vs 59.7%, p=0.0041). This difference was no longer significant when adjusted for age and menopausal status (odds ratio 0.68, p=0.075). In those sexually active, no significant differences were noted on the SAQ Pleasure and Discomfort scales.Differences in adjuvant treatment were not significantly associated with being sexually active or the SAQ subscales. BCS scored higher (worse) on the gynecological and bladder symptom scale than controls (0.66 vs 0.43, p=0.0036, adjusted difference 0.24, p=0.0029; 0.60 vs 0.41, p=0.02, adjusted difference 0.18, p=0.029 respectively), but no difference was seen in vasomotor scores. Gynecological symptom scores were greatest in BCS who received adjuvant chemotherapy. Conclusion Despite more frequent long-term gynecological and bladder symptoms, sexual health is similar in BCS and controls. Adjuvant chemotherapy is associated with persistent gynecological symptoms and interventions aimed at improving these could improve quality of life. Citation Format: Soldera SV, Ennis M, Lohmann AE, Goodwin PJ. Sexual health in long-term breast cancer survivors [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-12-22.

Attitude Toward One's Circumcision Status Is More Important than Actual Circumcision Status for Men's Body Image and Sexual Functioning.

Research exploring the impact of circumcision on the sexual lives of men has failed to consider men's attitudes toward their circumcision status, which may, in part, help to explain inconsistent findings in the literature. The current study explored the potential relationship between attitudinal factors toward one's circumcision status, timing of one's circumcision, and sexual correlates. A total of 811 men (367 circumcised as neonates, 107 circumcised in childhood, 47 circumcised in adulthood, and 290 intact) aged 19-84years (M=33.02, SD=12.54) completed an online survey. We assessed attitudes toward one's circumcision status, three domains of body image (Male Genital Image Scale, Body Exposure during Sexual Activities Questionnaire, Body Image Satisfaction Scale), and self-reported sexual functioning (International Index of Erectile Function). Men who were circumcised as adults or intact men reported higher satisfaction with their circumcision status than those who were circumcised neonatally or in childhood. Lower satisfaction with one's circumcision status-but not men's actual circumcision status-was associated with worse body image and sexual functioning. These findings identify the need to control for attitudes toward circumcision status in the study of sexual outcomes related to circumcision. Future research is required to estimate the number of men who are dissatisfied with their circumcision status, to explore the antecedents of distress in this subpopulation, and to understand the extent of negative sexual outcomes associated with these attitudes.

Hormone replacement therapy after risk-reducing salpingo-oophorectomy minimises endocrine and sexual problems: A prospective study

BackgroundThere has been some doubts raised in earlier studies about the efficacy of hormone replacement therapy (HRT) in reducing endocrine and sexual problems in women who have undergone a risk-reducing salpingo-oophorectomy (RRSO). MethodsIn this prospective, observational study, we recruited 178 premenopausal women with a high risk for ovarian cancer. Fifty-seven women opted for RRSO and 121 for gynaecological screening (GS). Women completed questionnaires before surgery (T1) and 3 (T2) and 9 (T3) months post surgery, or at equivalent time points for the GS-group. Menopausal symptoms were assessed with the Functional Assessment of Cancer Therapy–Endocrine Subscale (FACT-ES) and sexual functioning with the Sexual Activity Questionnaire (SAQ). Groups were compared using repeated measures mixed effect models for continuous variables, and generalised estimating equations for longitudinal ordered categorical data. ResultsTwenty-seven women who underwent RRSO used HRT after surgery (HRT-users) and 30 did not (HRT-non-users). There were no significant group differences at baseline on the outcome variables. Compared to the HRT-users, the HRT-non-users exhibited a significant increase in overall endocrine symptoms (p = 0.001, effect size (ES) = −0.40 and p < 0.001, ES = −0.59 at T1 and T2, respectively), and in sexual discomfort (p < 0.001, ES = 0.74 and p < 0.001, ES = 1.17). The effect size provides an indication of the magnitude of the observed group differences. An effect size of 0.50 or greater is generally considered to be clinically relevant. No significant differences over time were observed between the HRT-users and the GS-group on any of the outcomes. ConclusionOur results suggest that HRT use in the first year after RRSO has beneficial effects in terms of minimising endocrine symptoms and sexual symptoms in premenopausal women who have undergone RRSO.

Self-reported sexual health: Breast cancer survivors compared to women from the general population \u2013 an observational study

BackgroundCancer survivorship is of increasing importance in post-treatment care. Sexual health (SH) and femininity can be crucial issues for women surviving cancer. We aimed to determine a more complete understanding of the contribution that a breast cancer (BC) diagnosis and its treatment exert on patients’ follow-up SH. For this purpose, self-reported levels and predictors of SH in breast cancer survivors (BCS) were compared with those of women with no previous or current BC (WNBC).MethodsBCS and WNBC underwent a comprehensive, cross-sectional patient-reported outcome (PRO) assessment. Validated PRO instruments were used to measure SH, body image, anxiety and depression and menopausal symptoms. Assessments were performed within the routine clinical setting.Instruments used were the Sexual Interest and Desire Inventory - Female, Sexual Activity Questionnaire, Body Image Scale, Hospital Anxiety and Depression Scale and the Menopause-Specific Quality of Life Questionnaire.ResultsOne hundred five BCS (average time since diagnosis of 3 years) and 97 WNBC with a mean age of 49 years completed the assessment. SH was significantly worse in BCS compared to WNBC (p = 0.005; BCS SIDI-F mean = 24.9 vs. WNBC mean = 29.8). 68.8% of BCS and 58.8% of WNBC met criteria of a hypo-active sexual desire disorder. Higher depressive symptoms, higher age and lower partnership satisfaction were predictive for poorer SH in BCS.ConclusionSH problems are apparent in BCS and differ significantly from those seen in the general population. Consequently, BC survivorship care should include interventions to ameliorate sexual dysfunction and provide help with depressive symptoms and partnership problems, which are associated with poor BCS SH.

Sexual inactivity in partnered female cancer survivors

ObjectiveTo measure sexual activity in a clinic population of partnered female cancer survivors, and to better understand reasons for sexual inactivity in this population. Materials and methodsPartnered peri- or post-menopausal cancer survivors seen at a specialty clinic for menopause symptoms after cancer completed Fallowfield's Sexual Activity Questionnaire, quality of life measures (the Functional Assessment of Cancer Therapy General, Breast Cancer, and Endocrine Symptom Scales), and the Greene Climacteric Scale. Responses were compared between those who were sexually active and those who were not. ResultsOf 316 partnered women who reported sexual activity status, most were breast cancer survivors (n=268, 85%) and were sexually active (n=227, 72%). Women who were not sexually active (n=89, 28%) were slightly older than those who were active (53.1v 51.0 years, p=0.049) but did not differ in menopausal status, time since cancer diagnosis, or treatment with chemotherapy, anti-estrogenic endocrine therapy or menopausal hormone therapy. Loss of interest in sex (78%) and being too tired (44%) were the most common reasons for sexual inactivity. Those who were not sexually active were more likely to be dissatisfied with their sex lives (adjusted odds ratio (aOR) 3.52, 95% CI 1.66–7.48) and to have lost interest in sex (aOR 2.12, 95% CI 1.22–3.67). Compared with sexually active women, sexually inactive women were significantly less likely to feel sexually attractive or “able to feel like a woman” (respectively, aOR 2.51, 95% CI 1.01–6.24; aOR 2.21, 95% CI 1.32–3.71) and more likely to feel bothered by a weight change and self-conscious about the way they dressed, and to be bothered by hair loss (respectively, aOR 1.84, 95% CI 1.10–3.05; aOR 2.75, 95% CI 1.63–4.64; aOR 1.85, 95% CI 1.04–3.29). Those who were not sexually active had significantly lower average scores on breast-cancer-related quality of life than sexually active women but did not differ in physical, social or functional well-being or menopause-related quality of life. Pain with intercourse and vaginal dryness were equally common in both groups (respectively, sexually inactive 45.5% v. active 38.3%, aOR 1.28, 95%CI 0.75–2.18; 48.8% v. 49.5%, aOR 0.94, 95% CI 0.57–1.56). ConclusionsOver one-quarter of partnered cancer survivors in this clinic-based sample were not sexually active. Sexually inactive women were more dissatisfied with their sex lives, felt less attractive and more self-conscious about their appearance. The reasons for sexual inactivity in cancer survivors are multifaceted and complex and rates of vaginal dryness and dyspareunia did not differ between sexually active and inactive women, suggesting that interventions to improve sexual function which are limited to treating vaginal dryness are unlikely to be effective.

The effect of ovarian cancer screening on sexual activity and functioning: results from the UK collaborative trial of ovarian cancer screening RCT

Background:To examine the impact of multimodal (MMS) and ultrasound (USS) screening on the sexual activity and functioning of 22 966 women in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) RCT.Methods:Fallowfield’s Sexual Activity Questionnaire (FSAQ) was completed prior to randomisation, then annually in a random sample (RS) of women from MMS, USS and control groups. Any women in the study who required repeat screening due to unsatisfactory results formed an Events Sample (ES); they completed questionnaires following an event and annually thereafter.Results:Over time in the RS (n=1339) there was no difference between the MMS and USS groups in sexual activity compared with controls. In the ES there were significant differences between the USS group (n=10 156) and the MMS group (n=12 810). The USS group had lower pleasure scores (mean difference=−0.14, P=0.046). For both groups women who had ⩾2 repeat screens, showed a decrease in mean pleasure scores compared with their annual scores (mean difference=−0.16, P=0.005). Similarly mean pleasure scores decreased following more intensive screens compared with annual screening (mean difference=−0.09, P=0.046).Conclusions:Ovarian cancer screening did not affect sexual activity and functioning unless a woman had abnormal results and underwent repeated or higher level screening.

Preoperative psychosocial characteristics may predict body image and sexuality two years after risk-reducing mastectomy: a prospective study.

Risk-reducing mastectomy (RRM) in patients at high risk has become more available and the rates of both bilateral (BRRM) and contralateral (CRRM) procedures are increasing. For women opting for RRM, psychosocial well-being, body image and sexuality are known to be important patient-reported outcomes. The aim of the present study was to investigate baseline health-related quality of life (HRQoL) and emotional distress (anxiety and depression) as predictors of body image and sexuality two years after RRM in women undergoing CRRM and BRRM. This is a prospective cohort study including consecutive women opting for BRRM and breast cancer patients considering CRRM at Karolinska University Hospital during 1998-2010. The women were given a set of questionnaires to be completed at baseline before RRM (The Medical Outcomes Study 36-Item Short Form, The Hospital Anxiety and Depression Scale, and The Sexual Activity Questionnaire) and two years after RRM (all the above-mentioned questionnaires along with The Body Image Scale). Mean scores for all questionnaires were analysed using linear regression models and adjusted for age at RRM as well as calendar year. In total, 253 patients consented to participate in the study. Response rate at baseline and 2 years was 88% and 71%, respectively. In the BRRM group (healthy women), preoperative HRQoL and emotional distress were associated with body image and sexual problems two years after the procedure. No similar associations were found for the patients with breast cancer who underwent CRRM. The current study suggests that preoperative HRQoL and emotional distress may predict body image and sexual problems two years after RRM in healthy women, but not in breast cancer patients. Baseline psychosocial characteristics may be useful to identify women at risk for long-term body image and sexual problems following BRRM, but not among breast cancer patients opting for CRRM.

Older Adults’ Experiences of Sexual Difficulties: Qualitative Findings From the English Longitudinal Study on Ageing (ELSA)

There is a growing body of evidence demonstrating that sexual activity is important to the quality of life of older adults, and that it can be influenced by physical, psychological, and social factors. However, older adults’ experiences of sexual difficulties remain relatively unexplored. This article draws on qualitative data collected as part of the English Longitudinal Study of Ageing (ELSA). Participants answered a Sexual Relationships and Activities Questionnaire (SRA-Q), which included an open comment box for further details, 1,084 (1/7) of which were completed. These data were analyzed using Template Analysis, and findings on the experiences of sexual difficulties are presented in this article. Sexual difficulties were contextualized within the couple relationship and could be detrimental to the relationship, particularly if the partner would not seek professional help. Participants reported that sexual difficulties could also have a negative impact on psychological well-being, described mainly as frustration, depression, and sadness. For some participants the supportive nature of their relationship buffered these impacts. Few had sought professional help; those who had reported helpful and unhelpful experiences. These findings add to the limited evidence base and have implications for health care in the context of global aging and a growing recognition of older adults’ sexual rights.

Let's talk about sex – what do older men and women say about their sexual relations and sexual activities? A qualitative analysis of ELSA Wave 6 data

ABSTRACTIn 2012/2013 the English Longitudinal Study of Ageing (ELSA) included a comprehensive Sexual Relationships and Activities Questionnaire (SRA-Q). A total of 7,079 men and women mainly aged 50 to &gt;90, primarily heterosexual and in a coupled relationship, completed the SRA-Q, answering a series of questions about their attitudes to sexual relationships, their own sexual activities, problems and concerns with sexual functioning, and quality of intimate relationships. The questions aimed to gain insights into the ways in which sexual relations and activities related to health, wellbeing and other lifestyle factors change as people grow older. The primary mode of data collection was a tick box response to a series of questions. However, at the end of the questionnaire an open comment box was provided, which asked respondents whether there was anything else that they would like to say; 1,084 respondents provided additional information and these comments created a unique qualitative data-set. The analysis of the data then illustrated how people's health, relationships, experiences and perceptions of ageing, along with sexual satisfaction, impact on sexual relationships and activities.

Testicular prosthesis: Patient satisfaction and sexual dysfunctions in testis cancer survivors

We studied patient satisfaction about sexual activity after prosthesis implantation using validated questionnaires with the aim to discover if testicular prosthesis could be responsible of sexual dysfunctions (erectile dysfunction or premature ejaculation). We evaluated a total of 67 men who underwent radical orchiectomy for testicular cancer and a silicon testicular prosthesis implantation from January 2008 to June 2014 at our Hospital. These patients completed 5 validated questionnaires the day before orchiectomy and 6 months after surgery: the International Index of Erectile Function 5 (IIEF5), the Premature Ejaculation Diagnostic Tool (PEDT), the Body Exposure during Sexual Activities Questionnaire (BESAQ), the Body-Esteem Scale and the Rosenberg Self- Esteem Scale. We also evaluated 6 months after surgery any defects of the prosthesis complained by the patients. The questionnaires completed by patients didn't show statistically significant changes for erectile dysfunction (p &gt; 0.05) and premature ejaculation (p &gt; 0.05). On the contrary the psychological questionnaires showed statistically significant change for the BESAQ (p &lt; 0.001) and the Body Esteem Scale (p &lt; 0.001), but not for the Rosenberg Self-Esteem Scale (p &gt; 0,05). A total of 15 patients (22.37%) were dissatisfied about the prosthesis: the most frequent complaint (8 patients; 11.94%) was that the prosthesis was firmer than the normal testis. Testicular prosthesis implantation is a safe surgical procedure that should be always proposed before orchiectomy for cancer of the testis. The defects complained by patients with testicular prosthesis are few, they don't influence sexual activity and they aren't able to cause erectile dysfunction or premature ejaculation.

Sexual Dysfunction in Breast Cancer Survivors: Cross-Cultural Adaptation of the Sexual Activity Questionnaire for Use in Portugal.

The increasing survivor population of breast cancer has shifted research and practice interests into the impacts of thedisease and treatment in quality of life aspects. The lack of tools available in Portuguese to objectively evaluate sexual function led tothe development of this study, which aimed to cross-culturally adapt and validate the Sexual Activity Questionnaire for use in Portugal. The questionnaire was translated and back-translated, refined following face-to-face interviews with sevenbreast cancer survivors, and then self-administered by a larger sample at baseline and a fortnight later to test validity and reliability. Following cognitive debriefing (n = 7), minor changes were made and the Sexual Activity Questionnaire was then testedwith 134 breast cancer survivors. A 3-factor structure explained 75.5% of the variance, comprising the Pleasure, Habit and Discomfortscales, all yielding good internal consistency (Cronbach's α > 0.70). Concurrent validity with the FACt-An and the BCPT checklist wasgood (Spearman's r > 0.65; p-value < 0.001) and reliability acceptable (Cohen's k > 0.444). The Sexual Activity Questionnaire allowedthe identification of 23.9% of sexually inactive women, for whom the main reasons were lack of interest or motivation and not havinga partner. Patient-reported outcomes led to a more comprehensive and improved approach to cancer, tackling areas previouslyabandoned. Future research should focus on the validation of this scale in samples with different characteristics and even in the overallpopulation to enable generalizability of the findings. The adapted Sexual Activity Questionnaire is a valid tool for assessing sexual function in breast cancer survivors inPortugal.

How does adjuvant chemotherapy affect menopausal symptoms, sexual function, and quality of life after breast cancer?

The aim of the study was to determine the association between adjuvant chemotherapy for breast cancer and menopausal symptoms, sexual function, and quality of life. Participants attended a menopause clinic with a dedicated service for cancer survivors at a large tertiary women's hospital. Information about breast cancer treatments including adjuvant chemotherapy was collected from medical records. Menopausal symptoms were recorded with the Greene Climacteric Scale and Functional Assessment of Cancer Therapy, Breast Cancer, and Endocrine Symptom Subscales. Sexual symptoms were recorded using Fallowfield's Sexual Activity Questionnaire. Quality of life was measured with Functional Assessment of Cancer Therapy scales. The severity of vasomotor, psychological, or sexual symptoms (apart from pain) did not differ between those who had received adjuvant chemotherapy (n = 339) and other breast cancer survivors (n = 465). After adjustment for current age, time since menopause, and current use of antiestrogen endocrine therapy, the risk of "severe pain" with sexual intercourse was twice as common after chemotherapy (31.6% vs 20.0%, odds ratio [OR] 2.18, 95% CI 1.25-3.79). Those treated with chemotherapy were more likely to report "severe problems" with physical well-being (OR 1.92, 95% CI 1.12-3.28) and lower breast cancer-specific quality of life (OR 1.89 95% CI 1.13-3.18), but did not differ in other quality of life measures. In this large study of breast cancer patients presenting to a specialty menopause clinic, previous chemotherapy was not associated with current vasomotor or psychological symptoms. Severe pain with intercourse was significantly more common in those treated with adjuvant chemotherapy.

Sexuality after a cancer diagnosis: A population-based study.

BACKGROUNDThis study explored differences in sexual activity, function, and concerns between cancer survivors and cancer‐free controls in a population‐based study.METHODSThe data were from 2982 men and 3708 women who were 50 years old or older and were participating in the English Longitudinal Study of Ageing. Sexual well‐being was assessed with the Sexual Relationships and Activities Questionnaire, and cancer diagnoses were self‐reported.RESULTSThere were no differences between cancer survivors and controls in levels of sexual activity (76.0% vs 78.5% for men and 58.2% vs 55.5% for women) or sexual function. Men and women with cancer diagnoses were more dissatisfied with their sex lives than controls (age‐adjusted percentages: 30.9% vs 19.8% for men [P = .023] and 18.2% vs 11.8% for women [P = .034]), and women with cancer were more concerned about levels of sexual desire (10.2% vs 7.1%; P = .006). Women diagnosed < 5 years ago were more likely to report difficulty with becoming aroused (55.4% vs 31.8%; P = .016) and achieving orgasm (60.6% vs 28.3%; P < .001) and were more concerned about sexual desire (14.8% vs 7.1%; P = .007) and orgasmic experience (17.6% vs 7.1%; P = .042) than controls, but there were no differences in men.CONCLUSIONSSelf‐reports of sexual activity and functioning in older people with cancer are broadly comparable to age‐matched, cancer‐free controls. There is a need to identify the causes of sexual dissatisfaction among long‐term cancer survivors despite apparently normal levels of sexual activity and function for their age. The development of interventions addressing low sexual desire and problems with sexual functioning in women is also important and may be particularly relevant for cancer survivors after treatment. Cancer 2016;122:3883–3891. © 2016 American Cancer Society.

Sexual Health and Positive Subjective Well-Being in Partnered Older Men and Women.

We examine the associations between different patterns of sexual behavior and function and three indicators of subjective well-being (SWB) covering eudemonic, evaluative, and affective well-being in a representative sample of partnered older people. Using data from a Sexual Relationships and Activities Questionnaire (SRA-Q) in Wave 6 of the English Longitudinal Study of Ageing, latent class analysis identified groups characterized by distinctive patterns of sexual behavior and function and then examined their link to SWB. Eudemonic SWB was measured using a revised 15-item version of the CASP-19, evaluative SWB using the Satisfaction With Life Scale, and affective SWB using the 8-item version of the Centre for Epidemiologic Studies-Depression scale. Sexual behavior and function was best described by six classes among men and five classes among women. These ranged from high sexual desire, frequent partnered sexual activities, and few sexual problems (Class 1) to low sexual desire, infrequent/no sexual activity, and problems with sexual function (Class 5([women])/6([men])). Men and women who reported either infrequent/no sexual activity, or were sexually active but reported sexual problems, generally had lower SWB than those individuals identified in Class 1. Poorer SWB in men was more strongly associated with sexual function difficulties, whereas in women desire and frequency of partnered activities appeared more important in relation to SWB. Within the context of a partnered relationship continuing sexual desire, activity and functioning are associated with higher SWB, with distinctive patterns for women and men.

Hypnotic Relaxation Therapy and Sexual Function in PostmenopausalWomen: Results of a Randomized Clinical Trial

Sexual dysfunction is a common problem for postmenopausal women. This study, as part of a larger randomized controlled trial, examined the effect of hypnotic relaxation therapy on sexual dysfunction, a secondary study outcome, in postmenopausal women. Sexual function was assessed using the Sexual Activity Questionnaire (SAQ). Significant improvement in sexual pleasure and discomfort were reported following 5 weekly sessions of hypnotic relaxation therapy, compared with those receiving an attention control. Total SAQ scores showed significant improvement in the hypnotic relaxation therapy treatment group while holding baseline SAQ scores constant. Improvements showed a slight increase at the Week 12 follow-up. The results of this analysis provide initial support for the use of hypnotic relaxation therapy to improve sexual function in postmenopausal women.

Abstract P4-11-04: Program evaluation of a female sexual medicine and women's health program

Abstract Objectives: To evaluate the effectiveness of simple sexual/vaginal health treatment strategies in breast cancer patients/survivors seeking treatment at a female sexual medicine program, and to evaluate compliance and clinical outcomes. Methods: Demographics, medical information, and clinical assessments from 94 new visits with at least 1 follow-up from 09/12–10/14 were analyzed. The assessment form consists of a clinician evaluation with the Vaginal Assessment Scale (VAS) and Vulvar Assessment Scale (VuAS), and patient-reported outcomes (PROs) including the Sexual Activity Questionnaire (SAQ), Female Sexual Function Index (FSFI), and exploratory items. Compliance with treatment recommendations at the last visit were summarized. Changes from the first to last visit were compared with regard to clinical outcomes (e.g., vaginal pH, moisture), the VAS and VuAS, and the PROs (FSFI, SAQ, and confidence about future sexual activity). Results: The mean number of visits was 3 (range, 2-7). Mean age was 55.2 years (range, 29-48), 67% (n=63) were married or in an intimate relationship, and 94% (n=88) were menopausal. Seventy-seven percent (n=72) were on some form of active treatment, such as endocrine therapy (89%, 64/72). Only 15% (11/72) reported any hormonal supplementation (e.g., Vagifem). Treatment strategies included the use of vaginal moisturizers, lubricants with sexual activity, pelvic floor exercises, and dilator therapy. At last visit, 94% (80/85) of the women had complied with the clinical recommendation to moisturize 2 to 5+ times per week. Vaginal pH scores &amp;gt;6.5 declined from 31% (29/93) at Visit 1 to 20% (19/93) at the last visit (p=0.049). Vaginal (VAS) symptoms improved from the first to last visit (mean 1.2 to 0.59, p&amp;lt;0.001) as did the Vulvar (VuAS) symptoms (mean 0.78 to 0.57, p=0.007). Only 17% (15/19) had normal vaginal moisture at Visit 1, compared to 29% (26/90) at the last visit (p=0.04). Sixty-seven percent (59/88) reported performing pelvic floor exercises a few times per week to daily at their last visit. FSFI arousal mean scores improved from the first (mean=2.30) to last visit (mean=2.93) (p=0.003), and urinary incontinence rates declined from the first (58%, 32/55) to last visit (24%, 13/55). At Visit 1, 51% (43/85) of the women reported current sexual activity with a partner, and sexual activity rates increased over time—61% at last visit (52/85, p=0.049). FSFI total scores significantly improved from the first (mean=12.91) to last visit (mean=17.44) (p&amp;lt;0.001). Confidence about future sexual activity increased from 43% (34/79) at Visit 1 to 67% (53/79) at the last visit (p&amp;lt;0.001). Concerns about sexual/vaginal health (scale of 0-10) decreased over time, with 54% (43/80) rating their concern at 9 or 10 at the first visit and 28% (22/80) at the last visit (p&amp;lt;0.001). Conclusions: Breast cancer patients/survivors attending our female sexual medicine program reported improvement of vaginal and vulvar symptoms, sexual function and activity, and had clinical improvement over time on vaginal pH and moisture. Preliminary findings suggest that simple strategies, education, and support can improve vaginal/sexual health concerns in cancer survivorship. Citation Format: Carter J, Seidel B, Stabile C, Baser R, Eaton A, Goldfarb S, Goldfrank D. Program evaluation of a female sexual medicine and women's health program. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-11-04.