Guntupalli Saketh R, Sheeder Jeanelle, Ioffe Yevgeniya, Tergas Ana, Wright Jason D, Davidson Susan A, Behbakht Kian, Flink Dina M
*Department of Obstetrics and Gynecology, University of Colorado Cancer Center, Aurora, CO; †Department of Obstetrics and Gynecology, Loma Linda University Cancer Center, Loma Linda, CA; ‡Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY; and §Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, CO.
Int J Gynecol Cancer. 2017 Mar;27(3):603-607. doi: 10.1097/IGC.0000000000000906.
Sexual dysfunction can be a long-term issue for women with gynecologic cancer. This study assesses the extent of sexual and marital dysfunction women face following treatment of a gynecologic cancer.
A cross-sectional study of women with gynecologic cancer was conducted using a 181-item survey. Sexual dysfunction was measured by change in the Female Sexual Function Index score; marital dysfunction was measured by change in Intimate Bond Measure from prediagnosis to posttreatment. Paired t tests and Fisher exact test were used to compare women with dysfunction to those without dysfunction.
Three hundred twenty women were enrolled (mean age, 56.0 [SD, 12.0] years). Among all women, sexual function declined from a score of 21.3 (SD, 10.4) prior to 15.3 (SD, 10.2) (P < 0.001), and sexual activity decreased from 6.1 (SD, 6.8) to 2.6 (SD, 4.9) times per month following treatment (P < 0.001). Among the 208 women who were sexually active at the time of study, sexual dysfunction after treatment was associated with younger age (50.9 [SD, 11.7] years to 57.3 [SD, 12.3] years), ovarian (40.7% vs 30.7%) or cervical (21.0% vs 10.2%) cancer diagnosis, chemotherapy treatment (72.8% vs 50.4%), and being in a relationship (97.3% vs 82.7%). Among women in relationships, 27% experienced marital dysfunction.
Women who are younger, have an ovarian or cervical cancer diagnosis, receive chemotherapy, or are in a committed relationship are at particularly high risk of sexual dysfunction. These women should be provided information about the risks associated with their cancer treatment.
性功能障碍可能是妇科癌症女性患者的一个长期问题。本研究评估了妇科癌症女性患者在接受治疗后所面临的性和婚姻功能障碍的程度。
采用一项包含181个项目的调查问卷，对妇科癌症女性患者进行横断面研究。性功能障碍通过女性性功能指数评分的变化来衡量；婚姻功能障碍通过从诊断前到治疗后的亲密关系量表的变化来衡量。使用配对t检验和Fisher精确检验，将有功能障碍的女性与无功能障碍的女性进行比较。
共纳入320名女性（平均年龄56.0[标准差，12.0]岁）。在所有女性中，性功能评分从治疗前的21.3（标准差，10.4）降至15.3（标准差，10.2）（P<0.001），性活动频率从每月6.1（标准差，6.8）次降至治疗后的2.6（标准差，4.9）次（P<0.001）。在研究时仍有性活动的208名女性中，治疗后的性功能障碍与较年轻的年龄（50.9[标准差，11.7]岁对57.3[标准差，12.3]岁）、卵巢癌（40.7%对30.7%）或宫颈癌（21.0%对10.2%）诊断、化疗治疗（72.8%对50.4%）以及处于恋爱关系（97.3%对82.7%）有关。在处于恋爱关系的女性中，27%经历了婚姻功能障碍。
年龄较轻、被诊断为卵巢癌或宫颈癌、接受化疗或处于稳定恋爱关系的女性发生性功能障碍的风险尤其高。应为这些女性提供有关其癌症治疗相关风险的信息。
