Sexual problems are common among young women being treated for breast cancer, according to a recent study of Dutch women. Problems lessen after treatment ends, yet many women continue to have sexual difficulties.
The study was published in Supportive Care in Cancer by researchers from the Netherlands.
Background and Reason for the Study
Sexual problems related to treatment can affect both younger and older women. For young women, sexual problems may cause extra distress. Treatment can impact fertility and reproductive planning, as well as prompt early menopause and symptoms of it, including vaginal dryness, hot flashes and loss of estrogen.
Sexual difficulties may affect sexual self-image or cause worry about impacts on an existing relationship or on finding a partner. The sudden inability to have children may influence the way women perceive themselves and their feelings of femininity.
The study researchers wanted to:
- Determine the extent of sexual troubles in young women with breast cancer
- Compare that amount with the frequency of sexual difficulties in women of the same age range in the general Dutch population unaffected by breast cancer
- Identify any association between sexual problems and breast cancer treatments or side effects
- Learn if women with breast cancer wanted care for sexual difficulties and whether healthcare professionals were providing that care
Women age 45 and younger, diagnosed with breast cancer within the previous six years, were recruited through Dutch breast cancer organizations, support groups and online contacts.
An online questionnaire gathered information including age, ethnicity and marital status. Women responded about treatment, side effects and whether they had discussed changes in sexuality with healthcare providers. The researchers termed problems sexual dysfunctions when participants said they occurred regularly and caused personal distress.
The study looked for:
- Hypoactive sexual desire disorder, little or no interest in sex
- Sexual aversion disorder, a strong dislike or fear of sex
- Subjective arousal disorder, or no, low or brief arousal
- Vaginal lubrication problems
- Changes in the intensity, time or frequency of orgasms
- Pain during sex, either constant or recurrent (dyspareunia)
- Secondary vaginismus, involuntary muscle contraction around the vagina
Participants were 22 to 49 years old, with an average age of 38.7. Most were Dutch-born or from other European countries.
Of the 332 women who participated, 190 were still in treatment, including hormonal therapy. The remaining 141 women had completed treatment.
Treatment status—whether still in treatment or not—had a significant influence on sexual concerns. Women in treatment had more problems than did those who had completed treatment. Sexual problems were higher for both groups compared to same-age women in the general Dutch population.
In women still receiving treatment, 64 percent had one or more difficulty, including:
- Lubrication problems – 45 percent
- Orgasm problems – 31 percent
- Pain during intercourse – 30 percent
- Hypoactive sexual desire disorder – 23 percent
For women who had completed treatment, 45 percent experienced one or more problems, most often with:
- Lubrication – 23 percent
- Orgasm – 21 percent
- Pain during intercourse – 16 percent
Young women in the general population had much lower levels of these difficulties. Only 8.7 percent had lubrication problems, 10 percent had orgasm difficulties and 6 percent had pain during intercourse.
Some long-term sexual troubles appeared more often in women who had certain treatments or side effects:
- Lubrication problems were more common among those who had vaginal dryness or early menopause, or who took hormonal therapy
- Orgasm problems; these were related to dry mucous membranes and radical mastectomy
- Pain during intercourse, which was related to dry mucous membranes and early menopause
Half the women talked with a healthcare professional during treatment about sexual functioning. Providers usually brought up the issue. Only four out of 10 women who felt a need for care concerning sexual problems consulted a professional.
What This Means for You
You may have had difficulties with sexuality during or after treatment. This study shows that such problems are common among young women.
There are many safe and practical ways to deal with treatment-related sexual changes. Talk with a member of your healthcare team—a sexual medicine physician, breast cancer nurse, oncologist, social worker or counselor—for suggestions. You may also find a knowledgeable sexual health provider through ISSWSH or AASECT.
The LBBC Guide to Understanding Intimacy and Sexuality can help you understand difficulties, improve your sexual health and talk with your healthcare provider and your partner, if you have one. Find out more about managing changes in sex and intimacy, dating concerns, body image and fertility at the lbbc.org special information section for young women.
H Kedde, HBM van de Wiel, WCM Weijmar Schultz and C Wijsen. Sexual Dysfunction in Young Women with Breast Cancer, Supportive Care in Cancer, January 2013; 21(1): 271-280.
This article was supported by Cooperative Agreement Number DP11-1111 from The Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.