Sexual dysfunction after cervical cancer treatment

Correia, Rafaella Araújo; Bonfim, Cristine Vieira do; Feitosa, Kéllida Moreira Alves; Furtado, Betise Mery Alencar Sousa Macau; Ferreira, Daniela Karina da Silva; Santos, Solange Laurentino dos

doi:10.1590/S1980-220X2019029903636

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 54 • 2020 • https://doi.org/10.1590/S1980-220X2019029903636 linkcopy

Sexual dysfunction after cervical cancer treatment

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective To describe the sociodemographic and clinical characteristics and those related to the sexual life, and to identify sexual dysfunction in women after cervical cancer treatment.

Method Cross-sectional study including women aged ≥18 years and completion of the three-month treatment. Two instruments were used: form with sociodemographic, clinical and sexual life-related information; and the Female Sexual Function Index to assess the sexual function of sexually active participants, with score values ≤26 classified as sexual dysfunction. Descriptive statistics was used to check associations through the Mann-Whitney test and Pearson’s chi-square test or Fisher’s exact test.

Results Out of a total of 46 women, 15 (32.61%) had sexual intercourse after treatment and eight had an indication of sexual dysfunction (score 21.66; standard deviation=7.06). The types of treatment (p=0.03) and of radiotherapy (p=0.01), in addition to the staging of the disease (p=0.02) interfered with the sexual function. The most affected domains of the Female Sexual Function Index were lubrication (p=0.03) and pain (p=0.04).

Conclusion Sexual dysfunction was present in women studied and had a negative impact on quality of life.

Uterine Cervical Neoplasms; Women´s Health; Sexual Behavior; Antineoplastic Protocols; Oncology Nursing

Sexual history and sexual practice
Variables	n	%
Beginning of sexual activity
<18 years	39	84.78
≥18 years	7	15.22
Number of sexual partners
One partner	7	15.22
Two to three partners	14	30.43
Four to five partners	6	13.04
More than five partners	19	41.30
Sexual activity before treatment
Yes	31	67.39
No	15	32.61
Frequency of sexual intercourse per month before treatment (n=31)
≤4 intercourse/month	4	12.91
>4 intercourse/month	27	87.09
Currently sexually active
Yes	15	32.61
No	31	67.39
Frequency of sexual intercourse per month after treatment (n=15)
≤4 intercourse/month	4	26.67
>4 intercourse/month	11	73.33
Did cancer and/or treatment interfere with sex life?
Yes	27	58.70
No	19	41.30
Is it important to have sexual activity?
Yes	34	73.91
No	12	26.09

Clinical variables	n	%
Histological type of tumor
Squamous cell carcinoma	42	91.30
Adenocarcinoma	3	6.52
Other	1	2.17
Staging
Advanced disease	29	63.04
Early disease	17	36.96
Treatment performed
Non-surgical (CT/RT)*	28	60.87
Surgical + adjuvant (CT/RT)*	9	19.57
Surgical	9	19.57
Radiotherapy
Yes	35	76.09
No	11	23.91
Modality of radiotherapy performed (n=35)
Teletherapy + brachytherapy	24	68.57
Teletherapy	9	25.71
Brachytherapy	2	5.71

FSFI	Mean (95% CI)	Standard Deviation	Median	Min.	Max.
Desire	3.20(2.52-3.88)	1.07	3.30	1.2	5.4
Arousal	3.38(2.70-4.05)	1.06	3.30	1.8	5.1
Lubrication	3.65(2.68-3.62)	1.53	3.60	1.2	6.0
Orgasm	3.10(2.21-3.99)	1.41	2.60	1.6	6.0
Satisfaction	4.23(3.21-5.26)	1.61	4.60	1.6	6.0
Pain	4.10(3.01-5.19)	1.72	4.40	1.6	6.0
Total score	21.66(17.17-26.15)	7.06	21.85	10.9	32.3

Variables p*	Desire	Arousal	Lubrication	Orgasm	Satisfaction	Pain	Total score
Staging
Advanced disease	3.36±1.25	3.66±0.94	3.6±1.2	3.44±1.94	4.8±0.85	4.56±0.97	23.42±2.05
Early disease	3.09±1.01	3.18±1.17	3.69±1.83	3.43±1.79	3.83±1.96	3.78±2.12	20.98±9.26
p*	0.94	0.33	0.94	0.75	0.57	0.69	0.69
Treatment performed
Surgical	3.45±0.76	3.68±1.35	4.88±1.35	4.3±2	4.9±1.95	5.2±1.6	26.4±8.69
Non-surgical (CT/RT)	3.3±1.43	3.3±0.55	4.05±0.76	3.8±2.03	4.8±0.98	4.3±0.89	23.55±2.34
Surgical + Adjuvant (CT/RT)	2.85±1.14	3.15±1.34	2.03±0.67	2.2±0.24	3±1.33	2.8±1.88	16.03±5.02
p*	0.36	0.78	0.03	0.25	0.15	0.04	0.15
Radiotherapy
Yes	3.08±1.22	3.23±0.95	3.04±1.27	3±1.59	3.9±1.45	3.55±1.58	19.79±5.42
No	3.45±0.76	3.68±1.35	4.88±1.35	4.3±2	4.9±1.95	5.2±1.6	26.4±8.69
p*	0.39	0.55	0.05	0.40	0.17	0.06	0.13

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Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[TFN1001] *CT: chemotherapy; RT: radiotherapy.