title: Impact of pelvic radiotherapy on female sexuality.
abstract: OBJECTIVE
  To assess physical and psychological morbidity, sexual functioning and social and relationship satisfaction among women treated with pelvic radiotherapy.
  
  
  METHODS
  Observational (case-control) study of 199 women: 98 submitted to pelvic radiotherapy for the treatment of uterine, rectal or anal cancers and 101 without a personal history of cancer and similar socio-demographic variables. These completed a socio-demographic and clinical questionnaire, and validated measures of psychological health (DASS: Lovibond and Lovibond in Behav Res Ther 33:353-343, 1995), sexual function (FSFI: Rosen et al. in J Sex Marital Ther 26:191-208, 2007), social support (ESSS: Ribeiro in Analise Psicologica 3:547-558, 1999) and relationship satisfaction (IMS: Hudson in The WALMYR assessment scales scoring manual 1992).
  
  
  RESULTS
  Women submitted to pelvic irradiation reported a higher rate of adverse physical symptoms in the last month: fatigue 59 versus 25% (p < 0.001), lack of strength 42 versus 20% (p = 0.001), diarrhoea 24 versus 12% (p = 0.032), vaginal discharge 17 versus 7% (p = 0.024), skin erythema 9 versus 2% (p = 0.026). Levels of depression, anxiety and stress were higher among radiotherapy patients, but only reach statistical significance for the stress parameter (6.1 vs. 4.0, p = 0.012). Also these women reported lower scores of satisfaction with social support (57.2 vs. 62.2, p = 0.005) and sexual function (8.5 vs. 13.5, p = 0.049). No statistically significant differences occurred between the two groups regarding scores of relationship satisfaction (20.8 vs. 19.9, p = n.s.).
  
  
  CONCLUSIONS
  Our results suggested that pelvic radiotherapy had a negative impact on female sexuality. Thus, interventions that would help to reduce this impact need to be designed and integrated into routine clinical practice.
authors.affiliation: Department of Gynecology and Obstetrics, Coimbra University Hospital, Coimbra, Portugal. anaclaudiasr@sapo.pt
authors.forename: Ana Cláudia
authors.initials: AC
authors.lastname: Rodrigues
authors.forename: Rubina
authors.initials: R
authors.lastname: Teixeira
authors.forename: Tânia
authors.initials: T
authors.lastname: Teixeira
authors.forename: Sofia
authors.initials: S
authors.lastname: Conde
authors.forename: Paula
authors.initials: P
authors.lastname: Soares
authors.forename: Isabel
authors.initials: I
authors.lastname: Torgal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000523:psychology / Q000532:radiotherapy*; D016022:Case-Control Studies; D003967:Diarrhea / Q000209:etiology; D004890:Erythema / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D010388:Pelvis / Q000528:radiation effects; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000523:psychology / Q000532:radiotherapy*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology* / Q000523:psychology; D019529:Sexuality / Q000523:psychology / Q000528:radiation effects*; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D014594:Uterine Neoplasms / Q000523:psychology / Q000532:radiotherapy*; D019522:Vaginal Discharge / Q000209:etiology; D055815:Young Adult