Cancer adversely affects sexual functioning in young adults

More than half of young adults between ages 18 and 39 with a cancer diagnosis reported problems with sexual function, according to a 2-year longitudinal study published in the journal Cancer.

“Women in particular reported challenges, such as lack of interest, inability to relax and enjoy sex, difficulties in becoming sexually aroused, and to have an orgasm,” said lead author Chiara Acquati, PhD, an assistant professor of social work at the University of Houston.

Study participants were administered the Medical Outcomes Study (MOS) Sexual Functioning Scale. At baseline (within 4 months of a first diagnosis of any invasive cancer), there were 123 participants. At the second assessment, 6 months later, complete data were available for 107 patients, whereas 2 years after baseline, 95 participants returned the study materials.

The most common cancers diagnosed in the sample were leukemia (15.4%), breast cancer (14.6%), soft-tissue sarcoma (12.2%) and non-Hodgkin lymphoma (10.6%).

Roughly 25% of the individuals in the sample were still receiving treatment at the last assessment.

The percentage of women reporting issues in achieving sexual arousal and orgasm increased across assessments. And at 2 years, “nearly 53% of young adults still reported some degree of affected sexual functioning,” Dr. Acquati told Contemporary OB/GYN.

Overall, sexual dysfunction reached moderate to severe levels for nearly 25% of participants. “This has important implications for the well-being of the individual, because failure to address sexual health can contribute to long-term consequences related to identity development, interpersonal relationships and quality of life,” Dr. Acquati noted.

The analysis showed that increased probability of sexual dysfunction was reported over time and for cancer patients who were female, older, married or in a committed relationship, treated with chemotherapy, and reporting comorbid psychological distress and lower social support.

“To me, as a researcher who studies the impact of cancer on patients and their informal caregivers, the most intriguing finding was the fact that for women, being in a relationship increased the likelihood of reporting sexual problems over time; while for men, the likelihood of reporting sexual problems increased regardless of their relationship status,” Dr. Acquati said. “This suggests that sexual functioning is experienced differently among males and females and that different intervention modalities may be considered by sex and relationship status.”

From a women's healthcare perspective, “the worse outcomes observed in this study are consistent with data from the existing literature about the experience of young women coping with cancer, as they report decreased interest, arousal, and frequency of intercourse often over time,” Dr. Acquati said.

Younger women may be particularly vulnerable to the impact of cancer and cancer-related treatment. “A cancer diagnosis can affect their body image, their intimacy with a partner, and their ability to engage in sex because of vaginal dryness and dyspareunia,” Dr. Acquati explained.

Furthermore, chemotherapy often induces early menopause among younger patients. “Therefore, it is vital that a conversation about sex and sexual function occurs soon after diagnosis, and that this conversation continues to occur throughout the continuum of care,” Dr. Acquati said.

Development and testing of protocols that monitor sexual functioning over time and connect women to psychosocial interventions are also needed.“Detecting changes in the rate of sexual dysfunction over time may help to identify the appropriate timing to deliver these interventions,” “Dr. Acquati said.

Healthcare providers serving young adults with cancer should also be trained in sexual health to increase their confidence in initiating conversations, according to Dr. Acquati.