Sexual Dysfunction in Postmenopausal Women with Breast Cancer on Adjuvant Aromatase Inhibitor Therapy

Daniel María Lubián López; Carmen Aisha Butrón Hinojo; Manuel Sánchez-Prieto; Nicolás Mendoza; Rafael Sánchez-Borrego

doi:10.1159/000510079

Sexual Dysfunction in Postmenopausal Women with Breast Cancer on Adjuvant Aromatase Inhibitor Therapy

Breast Care (Basel). 2021 Aug;16(4):376-382. doi: 10.1159/000510079. Epub 2020 Oct 23.

Authors

Daniel María Lubián López^{1

2}, Carmen Aisha Butrón Hinojo³, Manuel Sánchez-Prieto⁴, Nicolás Mendoza⁵, Rafael Sánchez-Borrego⁶

Affiliations

¹ Department of Obstetrics and Gynecology, University Hospital of Puerto Real, Cádiz, Spain.
² Hospital Quirón Salud Campo de Gibraltar, University of Cádiz, Cádiz, Spain.
³ Department of Obstetrics and Gynecology, Hospital of Algeciras, Cádiz, Spain.
⁴ Department of Obstetrics and Gynecology, Institut Universitari Dexeus, Barcelona, Spain.
⁵ Department of Obstetrics and Gynecology, University of Granada, Granada, Spain.
⁶ Department of Obstetrics and Gynecology, DIATROS, Clínica de Atención a la Mujer, Barcelona, Spain.

Abstract

Introduction: The aim of this study was to investigate whether postmenopausal women with breast cancer (BC) on adjuvant aromatase inhibitor (AI) therapy have a higher prevalence of female sexual dysfunction (FSD). Second, the aim was to determine the quality of life (QoL) and level of anxiety depending on whether or not they are AI users.

Methods: A prospective cross-sectional study involving 168 patients was performed. Three questionnaires were carried out: sexual functioning was evaluated with the Female Sexual Function Index (FSFI), while the EORTC QLQ-BR23 measures to study QoL in patients with BC and the State-Trait Anxiety Inventory (STAI) questionnaire (trait and status) were used to assess anxiety status in patients under treatment with AIs or not.

Results: 47.6% (80/168) of the postmenopausal BC survivors were not sexually active (mean time after surgery: 48.6 months) despite a relatively low mean age (56.43 years). Postmenopausal AI-treated women had significantly worse sexual function as measured by the FSFI (23.40 ± 5.26 vs. 30.16 ± 2.24; p = 0.000). There were significant differences between both groups in all domains, except orgasm. The QoL score was 37.67 ± 7.38 in AI users versus 39.00 ± 1.44 among nonusers (p = 0.053). Patients under endocrine treatment also presented STAI scores significantly higher (25.83 ± 4.99 vs. 19.00 ± 7.12; p = 0.000). Trait anxiety was high in both groups, but this was not statistically significant.

Conclusions: We observed a high prevalence of sexual inactivity among BC survivors regardless of AI use. Patients with AI use presented significantly higher prevalence of FSD, worse QoL, and greater anxiety.

Keywords: Aromatase inhibitors; Breast cancer survivors; EORTC QLQ-BR23; Female Sexual Function Index; Sexual dysfunction; State-Trait Anxiety Inventory questionnaire.