63% of young women with cancer experience sexual dysfunction
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Compared with young women in the general population, those with a cancer diagnosis were more likely to report sexual dysfunction, according to a population-based, cross-sectional study.
Notably, almost two-thirds of all young women with cancer reported sexual dysfunction.
“How women’s sex life and romantic relationships are impacted by being diagnosed with cancer in young adulthood (diagnosis before the age of 40) is still largely unknown,” Lena Wettergren, PhD, RN, a professor at Uppsala University in Sweden, told Healio. “Therefore, we wanted to investigate prevalence of sexual dysfunction in common cancers in these age groups using a large population-based sample.”
Using Swedish national quality registries, Wettergren and colleagues identified women aged 18 to 39 years who were diagnosed with breast cancer, cervical cancer, ovarian cancer, lymphoma or a brain tumor between January 2016 and August 2017. The researchers asked these women to participate in the present study 1.5 years after their diagnoses, 694 of whom completed the study.
From 2017 to 2018, the women with cancer and 493 women without cancer from the general population who were aged 19 to 40 years completed surveys that included questions on sexual activity and function, body image, emotional distress and sociodemographic information.
Sexual dysfunction in women with vs. without cancer
In total, 83% of the cancer group and 87% of the comparison group reported having partnered sex and/or masturbating within the month before the survey, and 67% and 69%, respectively, had been sexually active with a partner during that time.
Women with cancer were 37% more likely to report sexual dysfunction in at least one domain compared with those who did not (63% vs. 53%; OR = 1.37; 95% CI, 1.06-1.78), and were almost twice as likely to have dysfunction in two or more domains (33% vs. 18%; OR = 1.97; 95% CI, 1.42-2.74). Domains included decreased interest in having sex, vaginal and vulvar discomfort, and other factors that affected sexual activity and function.
Specifically, women with breast, cervical or ovarian cancer — collectively termed reproductive cancers — were more likely to report dysfunction in at least one (OR = 1.69; 95% CI, 1.27-2.24) or two domains (OR = 2.5; 95% CI, 1.76-3.54) compared with women who did not have cancer.
Dysfunction by cancer type, treatment
The most commonly reported problems among women with cancer were lack of interest in sexual activity (45%), ability to reach orgasm (34%), satisfaction with sex life (22%) and vulvar discomfort (clitoral, 22%; labial, 28%).
Among women with cancer, those with reproductive cancers were more likely to have dysfunction in at least two domains compared with women who had lymphoma (breast OR = 2.62; 95% CI, 1.1-6.2; cervical OR = 4.15; 1.64-10.5; ovarian OR = 3.55; 95% CI, 1.03-12.28). Additionally, women who received more intense treatment had a higher risk for sexual dysfunction in at least two domains compared with women who underwent less intense treatment (OR = 2.13; 95% CI, 1.33-3.93).
Emotional distress (OR = 1.07; 95% CI, 1.04-1.11) and body image disturbances (OR = 1.05; 95% CI, 1.02-1.08) among women with cancer were also associated with sexual dysfunction in at least two domains.
“We did not expect sex problems to such an extent in this national sample of about 700 women with cancer,” Wettergren said. “Almost half of the women diagnosed with breast and gynecological cancer reported low interest in having sex and more than 20% experienced pain and discomfort in the genital area. It was a bit surprising that women treated for lymphoma and brain tumors did not have more sex problems than women in general.”
Although research on interventions is ongoing, Wettergren said sexual health needs to be addressed more throughout cancer treatment.