Partner status influences sexual problems and self-efficacy in survivors of breast cancer

Study concludes that partnered, postmenopausal women, who are survivors of breast cancer fare better with sexual problems resulting from treatments designed to increase risk of reccurence.

Vaginal dryness and painful intercourse are some of the more common adverse events of post-breast cancer treatment therapies and often lead to sexual dissatisfaction and an overall lower quality of life (QOL). However, a new study finds that partnered women may fare better than those without a partner. Study results are published online in Menopause, the journal of The North American Menopause Society (NAMS).

Breast cancer is the leading cancer diagnosis in women, with more than 266,000 new cases estimated in 2018. More than 70% of these cases occur in women aged older than 50 years. Adjuvant endocrine therapy (AET), such as tamoxifen, is often recommended for postmenopausal women for as long as 10 years after completion of breast cancer treatment as a means to limit the risk of cancer recurrence. Unfortunately, AET has many adverse effects, including sexual problems in the form of vaginal dryness, painful intercourse, and low sexual desire.

Previous studies have associated sexual problems with poor QOL, whereas others have shown that partnered survivors of breast cancer have better QOL than unpartnered survivors. However, this new study is the first known to examine how partner status influences the relationships between sexual problems and self-efficacy for managing sexual problems and QOL domains for postmenopausal survivors of breast cancer taking AET. Its findings suggest that unpartnered postmenopausal women with greater sexual problems or lower self-efficacy may be at a greater risk to experience decreased QOL than partnered women.

Study results appear in the article, "Partner status moderates the relationship between sexual problems and self-efficacy for managing sexual problems and psychosocial quality-of-life for postmenopausal breast cancer survivors taking adjuvant endocrine therapy."

Abstract

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.

METHODS:
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).

RESULTS:
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.

CONCLUSIONS:
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.

Reference

Dorfman CS, Arthur SS1, Kimmick GG, Westbrook KW, Marcom PK, Corbett C, Edmond SN, Shelby RA. Partner status moderates the relationships between sexual problems and self-efficacy for managing sexual problems and psychosocial quality-of-life for postmenopausal breast cancer survivors taking adjuvant endocrine therapy. Menopause. 2019 Apr 15. doi: 10.1097/GME.0000000000001337. [Epub ahead of print]

Content created April 2019