Lee Maria, Kim Yun Hwan, Jeon Myung Jae
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea.
Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, South Korea.
Psychooncology. 2015 Sep;24(9):1097-103. doi: 10.1002/pon.3772. Epub 2015 Feb 17.
We aim to examine changes in sexual activity and function among younger breast cancer survivors who were sexually active before diagnosis and to investigate risk factors for negative impacts on them.
An observational cohort study enrolled 304 premenopausal and sexually active women diagnosed with early stage breast cancer. Questionnaires were completed, and sexual activity was measured at two time points: after surgery, to assess sexual activity and function before diagnosis, and then at least 12 months after the completion of chemotherapy or endocrine therapy. For each domain of the Female Sexual Function Index, a score below 3 was classified as indicative of a sexual problem. Each sexual problem was considered to be dysfunctional if it was associated with distress.
The median age at the last survey was 46.0 years (range: 23-57). Of the participants, 35 (11.5%) became sexually inactive after treatment. Among the 269 women who remained sexually active, 31.6% were currently experiencing sexual dysfunction, which was significantly higher compared with the frequency before diagnosis. In the multivariate logistic regression model, chemo-related menopause, thyroid dysfunction, and depression were independent risk factors for sexual inactivity. Chemo-related menopause was a significant risk factor for sexual dysfunction.
Chemo-related menopause was significantly associated with both sexual inactivity and dysfunction after treatment. Thyroid dysfunction and depression were risk factors for sexual inactivity in younger breast cancer survivors.
我们旨在研究在诊断前有性活动的年轻乳腺癌幸存者的性活动和功能变化，并调查对其产生负面影响的风险因素。
一项观察性队列研究纳入了304名诊断为早期乳腺癌的绝经前且有性活动的女性。完成问卷调查，并在两个时间点测量性活动：手术后，以评估诊断前的性活动和功能，然后在化疗或内分泌治疗完成后至少12个月。对于女性性功能指数的每个领域，得分低于3被分类为表明存在性问题。如果每个性问题与痛苦相关，则被认为是功能失调的。
最后一次调查时的中位年龄为46.0岁（范围：23 - 57岁）。在参与者中，35名（11.5%）在治疗后停止了性活动。在269名仍有性活动的女性中，31.6%目前正经历性功能障碍，这与诊断前的频率相比显著更高。在多变量逻辑回归模型中，化疗相关的绝经、甲状腺功能障碍和抑郁是性活动停止的独立风险因素。化疗相关的绝经是性功能障碍的一个重要风险因素。
化疗相关的绝经与治疗后的性活动停止和功能障碍均显著相关。甲状腺功能障碍和抑郁是年轻乳腺癌幸存者性活动停止的风险因素。
