Sexual problems during the first 2 years of adjuvant treatment with aromatase inhibitors

J Sex Med. 2014 Dec;11(12):3102-11. doi: 10.1111/jsm.12684. Epub 2014 Aug 21.

Abstract

Introduction: Sexual dysfunction has only recently been recognized as a highly prevalent side effect of adjuvant aromatase inhibitor (AI) therapy for breast cancer.

Aims: A cross-sectional survey using standardized measures of female sexual function was designed to provide a detailed view of sexual problems during the first 2 years of adjuvant AI therapy and secondarily to examine whether sexual dysfunction leads to nonadherence to this therapy.

Methods: Questionnaires were mailed to all 296 women in a breast oncology registry who had been prescribed a first-time AI for localized breast cancer 18-24 months previously.

Main outcome measures: Items assessed medication adherence, demographic, and medical information. Scales included the Female Sexual Function Index, the Menopausal Sexual Interest Questionnaire, the Female Sexual Distress Scale-Revised, the Breast Cancer Prevention Trial Eight Symptom Scale to assess menopausal symptoms, and the Merck Adherence Estimator(®) .

Results: Questionnaires were returned by 129 of 296 eligible women (43.6%). Respondents were 81% non-Hispanic white with a mean age of 63 and 48% had at least a college degree. Only 15.5% were nonadherent. Ninety-three percent of women scored as dysfunctional on the Female Sexual Function Index, and 75% of dysfunctional women were distressed about sexual problems. Although only 52% of women were sexually active when starting their AI, 79% of this group developed a new sexual problem. Fifty-two percent took action to resolve it, including 24% who stopped partner sex, 13% who changed hormone therapies, and 6% who began a vaginal estrogen. Scores on the Adherence Estimator (beliefs about efficacy, value, and cost of medication) were significantly associated with adherence (P = 0.0301) but sexual function was not.

Conclusions: The great majority of women taking AIs have sexual dysfunction that is distressing and difficult to resolve. Most continue their AI therapy, but a large minority cease sexual activity.

Keywords: Aromatase Inhibitor; Breast Cancer; Medication Adherence; Sexual Dysfunction.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adjuvants, Immunologic / therapeutic use
  • Antineoplastic Agents / adverse effects*
  • Anxiety / chemically induced
  • Aromatase Inhibitors / adverse effects*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / psychology
  • Chemotherapy, Adjuvant / adverse effects
  • Cross-Sectional Studies
  • Female
  • Humans
  • Medication Adherence
  • Middle Aged
  • Patient Satisfaction
  • Sexual Dysfunction, Physiological / chemically induced*
  • Sexual Dysfunctions, Psychological / chemically induced*
  • Surveys and Questionnaires

Substances

  • Adjuvants, Immunologic
  • Antineoplastic Agents
  • Aromatase Inhibitors