ABSTRACT
Background: Breast cancer (BC) is considered a risk factor for sexual dysfunction, which may be associated with the diagnosis itself or with oncological treatments. However, sexual dysfunction often remains underdiagnosed and unaddressed among BC survivors. Aim: The study sought to evaluate the sexual function of postmenopausal BC survivors compared with postmenopausal women without BC. Methods: This case-control study included 178 postmenopausal BC survivors (stages I-III), 45 to 70 years of age, with amenorrhea for ≥12 months and sexually active. They were compared with 178 women without BC, matched (±2 years) for age and time since menopause in a 1:1 ratio. Sexual function was evaluated using the Female Sexual Function Index (FSFI), which consists of 6 domains (desire, arousal, lubrication, orgasm, satisfaction, and pain), with a total score ≤26.5 indicating risk of sexual dysfunction. Statistical analysis included Student's t test, chi-square test, and logistic regression (odds ratio [OR]). Outcomes: Evaluation of sexual function in postmenopausal women treated for BC. Results: Postmenopausal BC survivors showed poorer sexual function in the desire domain (P = .002). No significant differences were observed between groups in the other FSFI domains and total score (P > .05). Postmenopausal BC survivors had a higher prevalence of risk of sexual dysfunction (64.6% with a total score ≤26.5) compared with the control group (51.6%) (P = .010). Adjusted risk analysis for age and time since menopause revealed a higher risk of sexual dysfunction in BC survivors compared with women without cancer (OR, 1.98; 95% confidence interval, 1.29-2.96; P = .007). Among BC survivors, the use of hormone therapy was associated with a higher risk of sexual dysfunction (OR, 3.46; 95% confidence interval, 1.59-7.51; P = .002). Clinical Implications: Postmenopausal BC survivors should be regularly assessed before and throughout treatment to enable the early detection and diagnosis of sexual dysfunction. Strength and Limitations: The main strength is that this study might contribute to a better understanding of sexual function in postmenopausal BC survivors compared with women without BC. The main limitation is that while the FSFI is a valid and reliable tool for the evaluation of female sexual function, it does not allow a comprehensive diagnosis of sexual dysfunction, as it is not applicable to partners. Conclusion: Compared with postmenopausal women without BC, postmenopausal BC survivors face a higher risk of sexual dysfunction, especially when treated with adjuvant hormone therapy.
ABSTRACT
Objective: To assess the pattern of sexual performance in women treated for breast cancer. Methods: This is a cross-sectional study on women treated for breast cancer. Inclusion criteria: to have undergone the first-line therapy for cancer and the cancer not being classified as stage IV. Data on cancer were collected by the analysis of medical records. For the evaluation of sexual performance, women were submitted to individual interviews, with the application of the Quociente Sexual Versão Feminina (QSF) questionnaire. Sexual performance was classified as: bad, unfavorable, regular, good, and excellent. The diagnosis of sexual dysfunction was established to women with score ≤ 60. For descriptive analyses, absolute (n) and relative (%) frequencies were performed, and for the comparison between the quantitative variables the Student's t-test was used. Results: 31 women with a mean age of 55.2 years were included, 35% were classified as clinical stage II, 84% underwent conservative surgery, 65% underwent chemotherapy, and 80% used endocrinotherapy. Regarding sexual performance, 62% spontaneously think about sex, 35% are always interested in sex, and 51.7% have some degree of pain during intercourse. After calculating the score, it was concluded that 6.5% had bad sexual performance; 19.4%, unfavorable; 19.4%, regular; 41.9%, good; and 12.8%, excellent. The mean score was 58.7 points (standard deviation = 21.4, median of 64, minimum of 16, and maximum of 90 points), and 45.2% of women were diagnosed with sexual dysfunction. The provided treatments and the length of follow-up did not have a significant correlation with sexual performance. Conclusion: Most women treated for breast cancer had sexual performance classified as "good and excellent," although a significant percentage had a diagnosis of sexual dysfunction.
ABSTRACT
BACKGROUND: The objective of this study was to evaluate the emotional burden, psychological morbidity, and level of family accommodation in caregivers of obsessive-compulsive disorder (OCD) patients, according to sociodemographic and clinical factors. METHODS: Fifty Brazilian DSM-IV OCD patients and their caregivers were evaluated using the Family Accommodation Scale, the Zarit Burden Interview (ZBI), the Self-Report Questionnaire (caregivers), the Yale-Brown Obsessive-Compulsive Scale, and the Beck Depression Inventory (patients). Most caregivers (80%) were aged between 30 and 59 years and lived with the patient (88%). RESULTS: Forty-two percent presented a common mental disorder and their mean ZBI score was 28.9. Family accommodation was moderate in 26% and severe or very severe in 24%. Caregivers' levels of psychological morbidity, accommodation, and emotional burden were associated with each other and with the severity of patient obsessive-compulsive and depressive symptoms. CONCLUSIONS: The results suggest that caregivers of OCD patients have important levels of burden and psychological morbidity and should receive orientation and support to minimize this emotional impact.
