Skip to main content

Advertisement

SpringerLink
Log in

Sexual function and sex hormones in breast cancer patients

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Purpose

Breast cancer patients (BCP) are at risk of female sexual dysfunction (FSD). Our aim was to clarify the effects of treatment strategies, and steroid hormones levels on FSD.

Methods

We enrolled 136 BCP (46.9 ± 0.8 years), and 122 completed questionnaires. BCP were divided into four groups: 22 women with advanced breast cancer on neoadjuvant therapy (NAT), 48 on adjuvant therapy (AT), 30 taking hormonal therapy (HT) and 22 with metastatic cancer on first line chemotherapy (FLT). Fifty-eight healthy women (43 ± 2.8 years) were enrolled as controls. FSD was evaluated by FSFI, and sexual distress was assessed with FSDS-R. We have collected demographic data, laboratory values, and LH, FSH, total testosterone (T), and estradiol (E2) levels.

Results

BCP showed a prevalence of FSD of 69%, total FSFI score was 17. FSDS-R was 8.3. FSD had a prevalence of 72 % in NAT, 65% in AT, 77% in metastatic BCP under FLT, 67% in HT, compared with a prevalence of 20% in controls. BCP showed lower E2 than normal values, as well as T. LH and FSH were significantly elevated than normal values. Total FSFI score was positively correlated with T in 122 BCP, no significant correlation was found between E2 and FSFI. Significant differences were found between NAT and HT in lubrication, pain domains and total FSDS-R score, AT and HT in pain domain, AT and NAT in lubrication domain.

Conclusions

BCP are at high risk of developing FSD both for treatment choice and hormonal status, but they have not sexually related personal distress.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. D.M. Conde, A.M. Pinto-Neto, C. Cabello, D. Santos-Sá, L. Costa-Paiva, E.Z. Martinez, Quality of life in Brazilian breast cancer survivors age 45-65 years: associated factors. Breast J. 11(6), 425–432 (2005)

    Article  PubMed  Google Scholar 

  2. American Cancer Society. Cancer Facts & Figures 2015. (Atlanta: American Cancer Society 2015)

  3. S.L. Bober, J. Carter, S. Falk, Addressing female sexual function after cancer by internists and primary care providers. J. Sex. Med 10(Suppl 1), 112–119 (2013)

    Article  PubMed  Google Scholar 

  4. E. Gilbert, J.M. Ussher, J. Perz, Sexuality after breast cancer: a review. Maturitas 66(4), 397–407 (2010)

    Article  PubMed  Google Scholar 

  5. M.I. Maiorino, P. Chiodini, G. Bellastella, D. Giugliano, K. Esposito, Sexual dysfunction in women with cancer: a systematic review with meta-analysis of studies using the Female Sexual Function Index. Endocrine 54(2), 329–341 (2016)

    Article  CAS  PubMed  Google Scholar 

  6. J. Knapp, Sexual function as a quality of life issue: the impact of breast cancer treatment. J. Gynecol. Oncol. Nurs. 7, 37–40 (1997)

    Google Scholar 

  7. P. Fobair, D. Spiegel, Concerns about sexuality after breast cancer. Cancer J. 15(1), 19–26 (2009)

    Article  PubMed  Google Scholar 

  8. K. Abbott-Anderson, K.L. Kwekkeboom, A systematic review of sexual concerns reported by gynecological cancer survivors. Gynecol. Oncol. 124, 477–489 (2011)

    Article  PubMed  Google Scholar 

  9. S. Rajan, J. Foreman, M.G. Wallis, C. Caldas, P. Britton, Multidisciplinary decisions in breast cancer: does the patient receive what the team has recommended? Br. J. Cancer 108(12), 2442–2447 (2013)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. I. Harirchi, A. Montazeri, F. Zamani Bidokhti, N. Mamishi, K. Zendehdel, Sexual function in breast cancer patients: a prospective study from Iran. J. Exp. Clin. Cancer Res. 31, 20–26 (2012)

    Article  PubMed  PubMed Central  Google Scholar 

  11. J.A. Cavalheiro, A. Bittelbrunn, C.H. Menke, J.V. Biazús, N.L. Xavier, R. Cericatto, F. Schuh, C.V. Pinheiro, E.P. Passos, Sexual function and chemotherapy in postmenopausal women with breast cancer. BMC Women’s. Health 12, 28 (2012)

    Article  PubMed  PubMed Central  Google Scholar 

  12. R. Rosen, C. Brown, J. Heiman, S. Leiblum, C. Meston, R. Shabsigh, D. Ferguson, R. D’Agostino, The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. J. Sex Marital Ther. 26, 191–208 (2000)

    Article  CAS  PubMed  Google Scholar 

  13. L. Derogatis, A. Clayton, D. Lewis-D’Agostino, G. Wunderlich, Y. Fu, Validation of the female sexual distress scale-revised for assessing distress in women with hypoactive sexual desire disorder. J. Sex. Med. 5, 357–364 (2008)

    Article  PubMed  Google Scholar 

  14. G. Accardo, G. Vallone, D. Esposito, F. Barbato, A. Renzullo, G. Conzo, G. Docimo, K. Esposito, D. Pasquali, Testicular parenchymal abnormalities in Klinefelter syndrome: a question of cancer? Examination of 40 consecutive patients. Asian J. Androl. 17(1), 154–158 (2015)

    Article  PubMed  Google Scholar 

  15. J.M. Ussher, J. Perz, E. Gilbert, Information needs associated with changes to sexual well-being after breast cancer. J. Adv. Nurs. 69(2), 327–337 (2013)

    Article  PubMed  Google Scholar 

  16. I. Bartula, K.A. Sherman, The Female Sexual Functioning Index (FSFI): evaluation of acceptability, reliability, and validity in women with breast cancer. Support. Care Cancer 23(9), 2633–2641 (2015)

    Article  PubMed  Google Scholar 

  17. M. Krychman, L.S. Millheiser, Sexual health issues in women with cancer. J. Sex. Med. Suppl 1, 5–15 (2013)

    Article  Google Scholar 

  18. S. Keesing, L. Rosenwax, B. McNamara, A dyadic approach to understanding the impact of breast cancer on relationships between partners during early survivorship. BMC Women’s Health 16, 57 (2016)

    Article  PubMed  PubMed Central  Google Scholar 

  19. A.J. Carroll, S.R. Baron, R.A. Carroll, Couple-based treatment for sexual problems following breast cancer: A review and synthesis of the literature. Support. Care Cancer 24(8), 3651–3659 (2016)

    Article  PubMed  Google Scholar 

  20. V. Pumo, G. Milone, M. Iacono, S.R. Giuliano, A. Di Mari, C. Lopiano, S. Bordonaro, P. Tralongo, Psychological and sexual disorders in long-term breast cancer survivors. Cancer Manag. Res. 4, 61–65 (2012)

    PubMed  PubMed Central  Google Scholar 

  21. J. Farthmann, A. Hanjalic-Beck, J. Veit, B. Rautenberg, E. Stickeler, T. Erbes, M. Földi, A. Hasenburg, The impact of chemotherapy for breast cancer on sexual function and health-related quality of life. Support. Care Cancer 24(6), 2603–2609 (2016)

    Article  PubMed  Google Scholar 

  22. M.F. Tiezzi, J.M. de Andrade, A.P. Romão, D.G. Tiezzi, M.R. Lerri, H.A. Carrara, L.A. Lara, Quality of life in women with breast cancer treated with or without chemotherapy. Cancer Nurs. 48, 37 (2016)

    Google Scholar 

  23. J.J. Speer, B. Hillenberg, D.P. Sugrue, C. Blacker, C.L. Kresge, V.B. Decker, D. Zakalik, D.A. Decker, Study of sexual functioning determinants in breast cancer survivors. Breast J. 11(6), 440–447 (2005)

    Article  PubMed  Google Scholar 

  24. M. Moegele, S. Buchholz, S. Seitz, O. Ortmann, Vaginal estrogen therapy in postmenopausal breast cancer patients treated with aromatase inhibitors. Arch. Gynecol. Obstet. 285(5), 1397–1402 (2012)

    Article  CAS  PubMed  Google Scholar 

  25. M. Dahir, D. Travers-Gustafson, Breast cancer, aromatase inhibitor therapy, and sexual functioning: a pilot study of the effects of vaginal testosterone therapy. Sex. Med. 2(1), 8–15 (2014)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. S. Witherby, J. Johnson, L. Demers, S. Mount, B. Littenberg, C.D. Maclean, M. Wood, H. Muss, Topical testosterone for breast cancer patients with vaginal atrophy related to aromatase inhibitors: a phase I/II study. Oncologist 16(4), 424–431 (2011)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. D. Barton, J.A. Sloan, L.T. Shuster, P. Gill, J.D. Bearden, D.B. Johnson, P.J. Stella, S.A. Terstriep, F.N. Rana, D.M. Anderson, C.L. Loprinz, Impact of vaginal dehydroepiandosterone (DHEA) on vaginal symptoms in female breast cancer survivors: Trial N10C1 (Alliance). J. Clin. Oncol. 32, 5s (2014)

    Google Scholar 

  28. S. Pruthi, J.A. Simon, A.P. Early, Current overview of the management of urogenital atrophy in women with breast cancer. Breast J. 17(4), 403–408 (2011)

    Article  PubMed  Google Scholar 

  29. M.L. Krychman, A. Katz, Breast cancer and sexuality: multi-modal treatment options. J. Sex. Med. 9(1), 5–13 (2012)

    Article  CAS  PubMed  Google Scholar 

  30. B. Candy, L. Jones, V. Vickerstaff, A. Tookman, M. King, Interventions for sexual dysfunction following treatments for cancer in women. Cochrane Database Syst. Rev. (2016) https://doi.org/10.1002/14651858.CD005540

  31. S.R. Davis, S. Wahlin-Jacobsen, Testosterone in women-the clinical significance. Lancet Diabetes Endocrinol. 3(12), 980–992 (2015)

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medical, Neurological and Metabolic Sciences of Ageing, University of Campania “Luigi Vanvitelli”, Naples, 80138, Italy

    Antonio Gambardella, Daniela Esposito, Giacomo Accardo, Marianna Taddeo, Antonietta Letizia, Rossella Tagliafierro, Katherine Esposito & Daniela Pasquali

Authors
  1. Antonio Gambardella
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniela Esposito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giacomo Accardo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marianna Taddeo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Antonietta Letizia
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rossella Tagliafierro
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Katherine Esposito
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Daniela Pasquali
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniela Pasquali.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gambardella, A., Esposito, D., Accardo, G. et al. Sexual function and sex hormones in breast cancer patients. Endocrine 60, 510–515 (2018). https://doi.org/10.1007/s12020-017-1470-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-017-1470-7

Keywords

Search

Navigation