Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Breast Cancer Res Treat. 2023 Jul;200(2):257-264. doi: 10.1007/s10549-023-06981-5. Epub 2023 May 24.
Sexual health problems and anxiety are disruptive symptoms in breast cancer survivors; however, little is known about these symptoms in postmenopausal breast cancer survivors on aromatase inhibitors therapies. This study aimed to determine the relationship between anxiety and vaginal-related sexual health problems in this population.
We analyzed cross-sectional data from a cohort study of postmenopausal women breast cancer survivors receiving aromatase inhibitors. Vaginal-related sexual health problems were assessed with the Breast Cancer Prevention Trial Symptom Checklist. Anxiety was assessed with the anxiety subscale of the Hospital Anxiety and Depression Scale. We used multivariable logistic regression to evaluate relationship between anxiety and vaginal-related sexual health adjusted for clinical and sociodemographic variables.
Among 974 patients, 305 (31.3%) reported anxiety and 403 (41.4%) had vaginal-related sexual health problems. Compared to those without anxiety, patients with borderline and clinically abnormal anxiety reported higher rates of vaginal-related sexual health problems (36.8% vs. 49% and 55.7% respectively, p < 0.001). In multivariate analyses adjusted for clinical and sociodemographic factors, abnormal anxiety was associated with a higher rate of vaginal-related sexual health problems, with adjusted odds ratios of 1.69 (95% CI 1.06-2.70, p = 0.03). Vaginal-related sexual health problems were more frequent among patients who were under 65 years of age, received Taxane-based chemotherapy, reported depression, and were married/living with a partner (p < 0.05).
Among postmenopausal breast cancer survivors on aromatase inhibitors therapies, anxiety was significantly associated with vaginal-related sexual health problems. As treatments for sexual health problems are limited, results suggest that psychosocial interventions for anxiety could potentially be adapted to simultaneously address sexual health needs.
性健康问题和焦虑是乳腺癌幸存者的常见症状，但关于接受芳香化酶抑制剂治疗的绝经后乳腺癌幸存者的这些症状知之甚少。本研究旨在确定该人群中焦虑与阴道相关的性健康问题之间的关系。
我们分析了接受芳香化酶抑制剂治疗的绝经后乳腺癌幸存者队列研究的横断面数据。阴道相关的性健康问题采用乳腺癌预防试验症状清单进行评估。焦虑采用医院焦虑抑郁量表的焦虑分量表进行评估。我们使用多变量逻辑回归来评估调整了临床和社会人口统计学变量后，焦虑与阴道相关的性健康问题之间的关系。
在 974 名患者中，305 名（31.3%）报告有焦虑，403 名（41.4%）有阴道相关的性健康问题。与没有焦虑的患者相比，有边缘性和临床异常焦虑的患者阴道相关的性健康问题发生率更高（分别为 36.8%、49%和 55.7%，p<0.001）。在调整了临床和社会人口统计学因素的多变量分析中，异常焦虑与阴道相关的性健康问题的发生率较高相关，调整后的优势比为 1.69（95%CI 1.06-2.70，p=0.03）。年龄<65 岁、接受紫杉醇类化疗、报告抑郁和已婚/与伴侣生活的患者阴道相关的性健康问题更为常见（p<0.05）。
在接受芳香化酶抑制剂治疗的绝经后乳腺癌幸存者中，焦虑与阴道相关的性健康问题显著相关。由于治疗性健康问题的方法有限，结果表明，针对焦虑的心理社会干预措施可能会被适当地用于同时解决性健康需求。
