Sexual dysfunction in Brazilian women undergoing adjuvant endocrine therapy for breast cancer: prevalence and associated factors

This study aimed to describe the frequency of sexual dysfunction among women undergoing adjuvant endocrine therapy (ET) and explore its relationship with patients' clinical, social, and demographic characteristics. We evaluated women with a history of non-metastatic estrogen receptor-positive invasive breast carcinoma who had been receiving adjuvant ET for at least 6 months and reported at least one instance of sexual intercourse 4 weeks prior to study entry. Sexual dysfunction was assessed using the Female Sexual Function Index (FSFI). Demographic and medical information were extracted from medical records and data were analyzed using R software. Between June 2021 and March 2024, a total of 774 patients were recruited. The mean age was 56.5 years. The mean duration of ET was 3.2 years. Only 346 patients (44.8%) had engaged in sexual intercourse in the previous 4 weeks and among them, 276 (79.8%) reported sexual dysfunction (mean FSFI score = 20.83, standard deviation SD = 6.3). Patient with sexual dysfunction were older than those without (53 ± 10.4 vs. 48 ± 9.4 p = 0.0002) and exhibited significantly lower EORTC QLQ C30 and BR23 scores. The use of aromatase inhibitors (AI) versus tamoxifen was associated with sexual dysfunction, with a prevalence ratio of 1.17 for sexual dysfunction (p = 0.047). In this study 79.8% of patients experienced sexual dysfunction. Interventions, such as sex training by cancer professionals, patient education, and integrated survivorship programs could enhance the quality of life of these patients. Sexual dysfunction is a prevalent and impactful issue among breast cancer survivors undergoing ET.