Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC.
Division of Medical Oncology, Duke University, Durham, NC.
Menopause. 2019 Aug;26(8):823-832. doi: 10.1097/GME.0000000000001337.
Past studies indicate that >90% of breast cancer survivors taking adjuvant endocrine therapy (AET) experience menopausal symptoms including sexual problems (eg, vaginal dryness, dyspareunia); however, research examining the impact of these problems on quality-of-life is limited. This cross-sectional study examined (1) the impact of sexual problems and self-efficacy for coping with sexual problems (sexual self-efficacy) on quality-of-life (ie, psychosocial quality-of-life and sexual satisfaction), and (2) partner status as a moderator of these relationships.
Postmenopausal breast cancer survivors taking AET completed measures of sexual problems (Menopause-Specific Quality-of-Life [MENQOL] sexual subscale], sexual self-efficacy, psychosocial quality-of-life (MENQOL psychosocial subscale), and sexual satisfaction (Functional Assessment of Cancer Therapy-General item).
Bivariate analyses showed that women reporting greater sexual problems and lower sexual self-efficacy had poorer quality-of-life and less sexual satisfaction (all P-values < 0.05). Partner status moderated the relationship between sexual problems and psychosocial quality-of-life (P = 0.02); at high levels of sexual problems, unpartnered women experienced poorer psychosocial quality-of-life than partnered women. Partner status also moderated the relationship between self-efficacy and psychosocial quality-of-life (P = 0.01). Self-efficacy was unrelated to psychosocial quality-of-life for partnered women; for unpartnered women, low self-efficacy was associated with poorer quality-of-life. Partner status did not moderate the relationships between sexual problems or self-efficacy with sexual satisfaction.
Greater sexual problems and lower sexual self-efficacy were associated with poorer psychosocial quality-of-life and sexual satisfaction among postmenopausal breast cancer survivors taking AET. Interventions to address sexual problems and sexual self-efficacy, particularly among unpartnered women, may be beneficial for improving the well-being of postmenopausal breast cancer survivors on AET.
过去的研究表明，接受辅助内分泌治疗（AET）的乳腺癌幸存者中，超过 90%经历过更年期症状，包括性问题（如阴道干燥、性交困难）；然而，研究这些问题对生活质量的影响是有限的。本横断面研究考察了（1）性问题及其应对性问题的自我效能（性自我效能）对生活质量（即心理社会生活质量和性满意度）的影响，以及（2）伴侣状况作为这些关系的调节因素。
接受 AET 的绝经后乳腺癌幸存者完成了性问题（绝经特异性生活质量问卷 [MENQOL] 性分量表）、性自我效能、心理社会生活质量（MENQOL 心理社会分量表）和性满意度（癌症治疗功能评估一般项目）的测量。
双变量分析显示，报告有更多性问题和更低性自我效能的女性生活质量和性满意度较差（所有 P 值均<0.05）。伴侣状况调节了性问题与心理社会生活质量之间的关系（P=0.02）；在性问题较高的情况下，无伴侣的女性比有伴侣的女性心理社会生活质量较差。伴侣状况还调节了自我效能与心理社会生活质量之间的关系（P=0.01）。对于有伴侣的女性，自我效能与心理社会生活质量无关；对于无伴侣的女性，低自我效能与较差的生活质量相关。伴侣状况未调节性问题或自我效能与性满意度之间的关系。
接受 AET 的绝经后乳腺癌幸存者中，性问题较多和性自我效能较低与心理社会生活质量和性满意度较差有关。针对性问题和性自我效能的干预措施，特别是针对无伴侣的女性，可能有助于改善接受 AET 的绝经后乳腺癌幸存者的幸福感。
