The alarming level of sexual dysfunction among Brazilian women with early breast cancer undergoing adjuvant endocrine therapy

Abstract

Objective: This study aimed to determine the frequency of sexual dysfunction among women with early breast cancer on
adjuvant endocrine therapy and to explore its relationships with patients’ clinical and social characteristics and healthcare
insurance. Methodology: Women with a history of early-stage ER+ invasive carcinoma of the breast on adjuvant endocrine therapy for at least 6 months and at least one sexual intercourse in the previous 4 weeks were evaluated for sexual
dysfunction with the Female Sexual Function Index questionnaire. Demographic and clinical information was reviewed
from medical records. Data collection was done with the RedCap software, and statistical analyses were performed on
the software R (R Core Team (2022). Results: From June 2021 to March 2024, 774 patients were recruited in 15 institutions. The mean age was 56.8 years, 38.8% were premenopausal, and 65.1% received chemotherapy. The mean duration
of endocrine treatment was 3.7 years. Only 315 (54%) out of 774 patients in this study had a sexual intercourse in the previous 4 weeks before evaluation and were included in the analysis. Sexual dysfunction was found in 252 (89%) participants
with active sex life. Age was significantly associated with sexual dysfunction with women >40 years old having higher
rates (95.3%) compared with younger patients (10%, p=0.01). Patients without sexual dysfunction had significantly higher
EORTC QLQ C30 domain scores. ET duration between 2 and 5 years vs. <2 years, higher vs lower education level, EORTC
QLQ-BR23 breast symptoms, and sexual functioning higher scores were significantly associated with the occurrence of
sexual dysfunction in multivariate analysis (p<0.05). Conclusion: Sexual dysfunction is a great concern for women. In our
study, only 56.37% of women evaluated had sexual intercourse in the previous 4 weeks, and of those women, 89% reported
sexual dysfunction. This is a major health problem and strategies to improve this issue are crucial.