Sexual Dysfunction in Women with Cancer: A Systematic Review of Longitudinal Studies
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Protocol Registration
2.2. Search Strategy
2.3. Inclusion and Exclusion Criteria
2.4. Data Extraction
2.5. Quality Assessement
3. Results
4. Discussion
4.1. Instruments Used to Assess Sexual Dysfunctions
4.2. Incidence of Sexual Dysfunctions in Women with Cancer
4.3. Sexual Dysfunctions and Cancer
4.4. Other Risk Factors for Sexual Dysfunctions
4.5. Critical Analysis of the Quality of Studies
4.6. Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Databases | Language | Descriptors | Strategy |
---|---|---|---|
PubMed | English | Cancer, neoplasmas, “Sexual Dysfunction”, “sexual function” and women | (Cancer OR Neoplasms) AND (Sexual Dysfunction OR Sexual Function) AND (Women) |
LILACS | English, Portuguese, and Spanish | Cancer, neoplasmas, “Sexual Dysfunction”, “sexual function” and women Câncer, neoplasia, Dysfunção sexual, Função Sexual e mulheres Cáncer, neoplasias, disfunciones sexuales, función sexual, Mujeres | (Cancer OR Neoplasms) AND (Sexual Dysfunction OR Sexual Function) AND (Women) (Neoplasia OR Câncer) AND (Disfunção Sexual OR Função Sexual) AND (Mulheres) (Neoplasias OR Cáncer) AND (Disfunciones Sexuales OR Función Sexual) AND (Mujeres) |
SciELO | English, Portuguese, and Spanish | Cancer, neoplasmas, “Sexual Dysfunction”, “sexual function” and women Câncer, neoplasia, Dysfunção sexual, Função Sexual e mulheres Cáncer, neoplasias, disfunciones sexuales, función sexual, Mujeres | (Cancer OR Neoplasms) AND (Sexual Dysfunction OR Sexual Function) AND (Women) (Neoplasia OR Câncer) AND (Disfunção Sexual OR Função Sexual) AND (Mulheres) (Neoplasias OR Cáncer) AND (Disfunciones Sexuales OR Función Sexual) AND (Mujeres) |
CINAHL | English | Cancer, neoplasmas, “Sexual Dysfunction”, “sexual function” and women | (Cancer OR Neoplasms) AND (Sexual Dysfunction OR Sexual Function) AND (Women) |
Scopus | English | Cancer, neoplasmas, “Sexual Dysfunction”, “sexual function” and women | (Cancer OR Neoplasms) AND (Sexual Dysfunction OR Sexual Function) AND (Women) |
Web of Science | English | Cancer, neoplasmas, “Sexual Dysfunction”, “sexual function” and women | (Cancer OR Neoplasms) AND (Sexual Dysfunction OR Sexual Function) AND (Women) |
EMBASE | English | Cancer, neoplasmas, “Sexual Dysfunction”, “sexual function” and women | (Cancer OR Neoplasms) AND (“Sexual Dysfunction” OR “Sexual Function”) AND (Women) |
Study | Country | Study Design | Cancer Type | Number of Participants | Age (Mean) | Marital Status | Level of Education | Cancer Treatment | Follow-Up Period |
---|---|---|---|---|---|---|---|---|---|
Baessler, K.; 2021 [15] | Germany | Retrospective cohort | CC | 221 | LARVHG: 43 VALRRG: 45 TMMRG: 51 CG: 46 UGG: 51 | NR | NR | Surgery or radiotherapy | NP |
İzci, F.; 2020 [2] | Turkey | Prospective cohort | BC | 108 | CaG: 53 CG: 52.5 | 43% married | 40% middle or high school | Surgery, radiotherapy, chemotherapy, or hormonal therapy | NR |
Mayer, S.; 2019 [9] | Germany | Retrospective cohort | BC and OC | 305 | BC: 56 OC: 53 CG: 46 | BC: 68.9% OC: 62.0% CG: 65% Married | NR | Surgery, chemotherapy, or hormonal therapy | NP |
Buckingham, L.; 2019 [16] | United States | Prospective longitudinal | EC | 425 | CaG: 63 CG: 57 | NR | NR | Surgery, radiotherapy, or chemotherapy | Five years |
Heinzler, J.; 2018 [17] | Germany | Case-control | CC | 166 | CaG I: 35.9 CaG II: 34.1 CG: 30.9 | CaG I: 77% CaG II: 73% CG: 58% In a relationship | CaG I: 72% CaG II: 70% CG: 69% Completed high school | Surgery or chemotherapy | Six months |
Soldera, S.V.; 2018 [1] | Canada | Prospective cohort | BC | 407 | CaG: 62 CG: 69 | CaG: 64% CG: 69% Married | NR | Surgery, chemotherapy, or hormonal therapy | NP |
Corrêa, C.S.L.; 2016 [26] | Brazil | Case-control | CC | 74 | CaG: 51.2 CG: 50.5 | CaG: 51.4% CG: 73% Had a partner | CaG: 54.1% CG: 62.2% Low schooling level | Surgery, radiotherapy, or chemotherapy | NP |
Aerts, L.; 2015 [18] | Belgium | Prospective longitudinal | EC | 252 | CaG: 62.9 BeG: 53.3 CG: 59.9 | CaG: 71% BeG: 86% CG: 69% Cohabitation or married | Gca: 40% BeG: 43% CG: 77% ≥Bachelor | Surgery | Two years |
Aerts, L.; 2014 [20] | Belgium | Prospective longitudinal | BC | 230 | GTC: 57.2 GM: 54.5 CG: 56.1 | GTC: 80% GM: 83% CG: 79% Cohabitation or married | GTC: 46% GM: 43% CG: 27% ≥ Bachelor | Surgery, radiotherapy, chemotherapy, or hormonal therapy | One year |
Froeding, L.P.; 2014 [19] | Denmark | Prospective longitudinal | CC | 80 | RVTG: 29 RAHG: 42 CG: 28.5 | RVTG: 72% RAHG: 88% CG: 80% Had a partner | RVTG: 72.2% RAHG: 81.2% CG: 50% Higher education | Surgery | One year |
Aerts, L.; 2014 [20] | Belgium | Prospective longitudinal | VC | 58 | VC: 57.38 CG: 55.28 | VC: 65% CG: 73% Cohabitation or married | VC: 31% CG: 55% ≥ Bachelor | Surgery | One year |
Juraskova, I.; 2013 [27] | Australia | Prospective longitudinal | CC and EC | 165 | CaG: 50.9 BeG: 46.9 PIG: 28.1 | CaG: 72% BeG: 63% Married PIG: 71% other | CaG: 57% ≤ High school BeG: 38% PIG: 42% Higher education | Surgery, radiotherapy, chemotherapy, or brachytherapy | Six months |
Pérez, M.; 2010 [21] | United States | Prospective longitudinal | BC | 1033 | DCIS: 57.0 Stage I: 59.1 Stage IIA: 54.5 CG: 56.5 | DCIS: 63.1% Stage I: 62.3% Stage IIA: 57.5% CG: 65.6% Married | DCIS: 71% Stage I: 65% Stage IIA: 76.2% CG: 74.9 > High school | Surgery, radiotherapy, chemotherapy, or hormonal therapy | Two years |
Abasher, S.M.; 2009 [24] | Sudan | Prospective cohort | BC | 200 | CaG: 45% aged 25 to 39 years CG: 44% aged 40 to 49 years | CaG and CG: 100% married | CaG: 32% Elementary school CG: 30% High school | Surgery, radiotherapy, chemotherapy, or hormonal therapy | NP |
Jensen, P.T.; 2003 [22] | Denmark | Prospective longitudinal | CC | 354 | CaG: 55 CG: 55 | CaG: 64% CG: 75% Had a partner | NR | Surgery, radiotherapy, or chemotherapy | Two years |
Andersen, B.L.; 1989 [23] | United States | Prospective longitudinal | GyC | 122 | CaG: 42 CG: 39 BeG: 42 | NR | NR | Surgery, radiotherapy, or chemotherapy | One year |
Study | Assessment Instrument | Sexual Dysfunctions Assessment | Sexual Dysfunctions | Incidence of Sexual Dysfunctions | Risk of Sexual Dysfunctions (R2) | Domains of Sexual Function Affected | Sexually Active Women | Reason for Sexual Inactivity |
---|---|---|---|---|---|---|---|---|
Baessler, K.; 2021 [15] | PFQ—German version | Scores ≥ 1 | Present | 40% | NR | NR | 71% | No partner (47%), impotent partner (15%), dyspareunia (12%), vaginal dryness (6%), and low sexual desire (6%) |
İzci, F.; 2020 [2] | ASEX | Scores ranged from 5 to 30. High scores indicate high sexual dysfunction | Present Difference between groups specially in the pre-treatment phase (21.39 ± 5) | NR | NR | Desire, psychological arousal, physiological arousal, orgasm | NR | NR |
Mayer, S.; 2019 [9] | SAQ and items 11 to 13 of the FSFI | High scores in the SAQ indicate more pleasure, discomfort, and higher sexual frequency than usual | Present | NR | NR | Satisfaction, discomfort, and frequency of sexual activities | BC 45.9%, OC 56.5%, and CG 76.7% | No sexual interest BC: 42.4% OC: 58.3% No partner CG: 41.7% |
Buckingham, L.; 2019 [16] | PISQ | Maximum score = 48. High scores indicate good sexual function | Absent No alterations between groups Mean score = 33 | NA | NA | NR | Both groups > 60% | NR |
Heinzler, J.; 2018 [17] | FSFI and EORTC QLQ-CX24 | FSFI scores < 26.55 indicate sexual dysfunction | Present Group mean: S1: 23.8 ± 9.7 S2: 25.3 ± 7.5 | NR | 3.5 (p = 0.0004) | Desire, arousal, satisfaction, and pain | NR | NR |
Soldera, S.V.; 2018 [1] | SAQ | High scores indicate more pleasure, discomfort, and higher sexual frequency than usual | Absent Not altered compared with the CG and adjuvant therapy | NA | NA | NR | NR | NR |
Corrêa, C.S.L.; 2016 [26] | FSFI | Scores < 26.0 indicate sexual dysfunction | Present CaG: (mean = 21.72) | 80% | Desire, arousal, lubrication, orgasm, satisfaction, and discomfort | GCa: 40.5% GC: 75.7% | No partner CaG: 32.4% GC: 66.7% | |
Aerts, L.; 2015 [18] | SSFS | SSFS ≥ 5 | Present (p < 0.01) | NR | NR | EC showed higher pain during the beginning of vaginal penetration | NR | NR |
Aerts, L.; 2014 [20] | SSFS | SSFS ≥ 5 | Present (p < 0.01) | NR | NR | Desire, arousal, and orgasm in the BCT group | NR | NR |
Froeding, L.P.; 2014 [19] | FSFI, FSDS, and SVQ | FSFI < 26.55 | Present | RVTG: 44.4% RAHG: 31.3% | NR | Desire RVTG:44.5% RAHG: 43.8% | RVTG:88.9% RAHG: 81.3% CG: 96.7% | NR |
Aerts, L.; 2014 [20] | SSFS and SSPQ | SSFS ≥ 5 | Present | NR | NR | Desire, arousal, and orgasm | VC 52% CG: NR | NR |
Juraskova, I.; 2013 [27] | DSFI | Score > 16.5 | Present (p > 0.05) CaG: Baseline: 5.41 (0.27) 6 months: 4.47 (0.37) GB: Baseline: 5.78 (0.30) 6 months: 5.42 (0.40) GPI: Baseline: 5.29 (0.52) 6 months: 4.27 (0.70) | NR | NR | Desire | CaG: 14.08% BeG: 15.27% PIG: 13.61% | NR |
Abasher, S.M.; 2009 [24] | WSFQ | Scores range from 17 to 85. High scores indicate positive sexual function | Present (p < 0.001). Specially in patients during chemo or radiotherapy | NR | NR | Desire and satisfaction | NR | NR |
Pérez, M.; 2010 [21] | Created by the authors | 4-point Likert scale. High mean scores indicate more sexual dysfunction | Present Sexual function was altered in patients with mastectomy (p < 0.05), chemotherapy (p < 0.05), and radiotherapy and hormonal therapy (p < 0.05) | NR | 2.7 (p = 0.0339) | Sexual interest | CDIS: 57% Stage I: 60.8% Stage IIA: 56.2% CG: 63.7% | NR |
Jensen, P.T.; 2003 [22] | SVQ and UGMQ | Used in longitudinal studies | Present | NR | 12 months Dyspareunia: 4.8*(95%CI: 1.4 to 16.6) Orgasm: 1.5* (95%CI: 1.1 to 2.2) Lubrication: 7.6*(95%CI: 3.2 to 18.1) Satisfaction: 2.1* (95%CI: 1.3 to 3.5) | Lubrication | CaG: 53% CG: 55% | NR |
Andersen, B.L.; 1989 [23] | DSFI | > 16.5 | Present | 30% | NR | Desire | NR | NR |
Study | Q1 | Q2 | Q3 | Q4 | Q5 | Q6 | Q7 | Q8 | Q9 | Q10 | Q11 | Q12 | Q13 | Q14 | Total |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Andersen, B.L.; 1989 [23] | ✓ | - | ✓ | ✓ | - | ✓ | ✓ | ✓ | ✓ | NA | ✓ | NR | ✓ | ✓ | 10 |
Pérez, M.; 2010 [21] | ✓ | ✓ | ✓ | ✓ | - | ✓ | ✓ | ✓ | ✓ | NA | - | NR | ✓ | ✓ | 10 |
Froeding, L.P.; 2014 [19] | ✓ | ✓ | NR | ✓ | - | ✓ | ✓ | ✓ | ✓ | NA | ✓ | NR | - | ✓ | 9 |
Jensen, P.T.; 2003 [22] | ✓ | ✓ | ✓ | ✓ | - | ✓ | ✓ | ✓ | ✓ | NA | ✓ | NR | - | - | 9 |
Soldera, S.V.; 2018 [1] | ✓ | ✓ | ✓ | ✓ | - | ✓ | ✓ | NA | ✓ | NA | ✓ | NR | NA | ✓ | 9 |
Baessler, K.; 2021 [15] | ✓ | ✓ | ✓ | - | ✓ | ✓ | ✓ | ✓ | - | NA | ✓ | NR | NA | - | 8 |
Mayer, S.; 2019 [9] | ✓ | ✓ | ✓ | - | - | ✓ | ✓ | - | ✓ | NA | ✓ | NR | NA | ✓ | 8 |
Buckingham, L.; 2019 [16] | ✓ | ✓ | - | ✓ | - | ✓ | ✓ | NA | ✓ | NA | ✓ | NR | - | ✓ | 8 |
Heinzler, J.; 2018 [17] | ✓ | ✓ | ✓ | ✓ | - | ✓ | - | - | ✓ | NA | ✓ | NR | - | ✓ | 8 |
Aerts, L.; 2015 [18] | ✓ | - | ✓ | ✓ | - | ✓ | ✓ | NA | ✓ | NA | ✓ | NR | - | ✓ | 8 |
Aerts, L.; 2014 [20] | ✓ | ✓ | ✓ | ✓ | - | ✓ | ✓ | - | ✓ | NA | ✓ | NR | - | - | 8 |
Corrêa, C.S.L.; 2016 [26] | ✓ | ✓ | NR | ✓ | - | ✓ | - | NA | ✓ | NA | ✓ | NR | NA | ✓ | 7 |
Juraskova, I.; 2013 [27] | ✓ | - | - | NR | - | ✓ | - | ✓ | ✓ | NA | ✓ | NR | ✓ | ✓ | 7 |
İzci, F.; 2020 [2] | ✓ | ✓ | NR | ✓ | - | ✓ | - | NA | ✓ | NA | ✓ | NR | NR | - | 6 |
Abasher, S.M.; 2009 [24] | ✓ | ✓ | ✓ | ✓ | - | - | - | NA | - | NA | ✓ | NR | NA | - | 5 |
Aerts, L.; 2014 [20] | ✓ | - | - | ✓ | - | - | - | NA | - | NA | ✓ | NR | NA | - | 3 |
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Sousa Rodrigues Guedes, T.; Barbosa Otoni Gonçalves Guedes, M.; de Castro Santana, R.; Costa da Silva, J.F.; Almeida Gomes Dantas, A.; Ochandorena-Acha, M.; Terradas-Monllor, M.; Jerez-Roig, J.; Bezerra de Souza, D.L. Sexual Dysfunction in Women with Cancer: A Systematic Review of Longitudinal Studies. Int. J. Environ. Res. Public Health 2022, 19, 11921. https://doi.org/10.3390/ijerph191911921
Sousa Rodrigues Guedes T, Barbosa Otoni Gonçalves Guedes M, de Castro Santana R, Costa da Silva JF, Almeida Gomes Dantas A, Ochandorena-Acha M, Terradas-Monllor M, Jerez-Roig J, Bezerra de Souza DL. Sexual Dysfunction in Women with Cancer: A Systematic Review of Longitudinal Studies. International Journal of Environmental Research and Public Health. 2022; 19(19):11921. https://doi.org/10.3390/ijerph191911921
Chicago/Turabian StyleSousa Rodrigues Guedes, Thais, Marcello Barbosa Otoni Gonçalves Guedes, Rebeca de Castro Santana, José Felipe Costa da Silva, Amanda Almeida Gomes Dantas, Mirari Ochandorena-Acha, Marc Terradas-Monllor, Javier Jerez-Roig, and Dyego Leandro Bezerra de Souza. 2022. "Sexual Dysfunction in Women with Cancer: A Systematic Review of Longitudinal Studies" International Journal of Environmental Research and Public Health 19, no. 19: 11921. https://doi.org/10.3390/ijerph191911921
APA StyleSousa Rodrigues Guedes, T., Barbosa Otoni Gonçalves Guedes, M., de Castro Santana, R., Costa da Silva, J. F., Almeida Gomes Dantas, A., Ochandorena-Acha, M., Terradas-Monllor, M., Jerez-Roig, J., & Bezerra de Souza, D. L. (2022). Sexual Dysfunction in Women with Cancer: A Systematic Review of Longitudinal Studies. International Journal of Environmental Research and Public Health, 19(19), 11921. https://doi.org/10.3390/ijerph191911921