title: Prevalence and predictors of sexual dysfunction in long-term survivors of marrow transplantation.
abstract: OBJECTIVE
  To describe the prevalence of sexual difficulties in men and women after marrow transplantation (MT), and to define medical, demographic, sexual, and psychologic predictors of sexual dysfunction 3 years after MT.
  
  
  METHODS
  Four hundred seven adult MT patients were assessed pretransplantation. Survivors repeated measures of psychologic and sexual functioning at 1 and 3 years posttransplantation.
  
  
  RESULTS
  Data were analyzed from 102 event-free 3-year survivors who defined themselves as sexually active. Men and women did not differ in sexual satisfaction pretransplantation. At 1 and 3 years posttransplantation, women reported significantly more sexual dysfunction than men. Eighty percent of women and 29% of men reported at least one sexual problem by 3 years after MT. No pretransplantation variables were significant predictors of 3-year sexual satisfaction for women. For men, pretransplantation variables of older age, poorer psychologic function, not being married, and lower sexual satisfaction predicted sexual dissatisfaction at 3 years (R2=.28; P < .001). Women who were more dissatisfied 3 years after MT did not receive hormone replacement therapy (HRT) at 1 -year posttransplantation and were less satisfied at 1 year, but not pretransplantation (R2=.35; P < .001).
  
  
  CONCLUSIONS
  Sexual problems are significant in the lives of MT survivors, particularly for women. Although HRT before 1 year posttransplantation improves sexual function, it does not ensure sexual quality of life. Intervention for women is needed to apply hormonal, mechanical, and behavioral methods to prevent sexual difficulties as early after transplantation as possible.
authors.affiliation: Fred Hutchinson Cancer Research Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Veterans Affairs Puget Sound Health Care System, Seattle 98109-1024, USA. ksyrjala@fhcrc.org
authors.forename: K L
authors.initials: KL
authors.lastname: Syrjala
authors.forename: S L
authors.initials: SL
authors.lastname: Roth-Roemer
authors.forename: J R
authors.initials: JR
authors.lastname: Abrams
authors.forename: J M
authors.initials: JM
authors.lastname: Scanlan
authors.forename: M K
authors.initials: MK
authors.lastname: Chapko
authors.forename: S
authors.initials: S
authors.lastname: Visser
authors.forename: J E
authors.initials: JE
authors.lastname: Sanders
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors