title: Sexual functioning among endometrial cancer patients treated with adjuvant high-dose-rate intra-vaginal radiation therapy.
abstract: OBJECTIVE
  We used the Female Sexual Function Index (FSFI) to investigate the prevalence of sexual dysfunction (SD) and factors associated with diminished sexual functioning in early stage endometrial cancer (EC) patients treated with simple hysterectomy and adjuvant brachytherapy.
  
  
  METHODS
  A cohort of 104 patients followed in a radiation oncology clinic completed questionnaires to quantify current levels of sexual functioning. The time interval between hysterectomy and questionnaire completion ranged from <6 months to >5 years. Multivariate regression was performed using the FSFI as a continuous variable (score range, 1.2-35.4). SD was defined as an FSFI score of <26, based on the published validation study.
  
  
  RESULTS
  SD was reported by 81% of respondents. The mean (± standard deviation) domain scores in order of highest-to-lowest functioning were: satisfaction, 2.9 (± 2.0); orgasm, 2.5 (± 2.4); desire, 2.4 (± 1.3); arousal, 2.2 (± 2.0); dryness, 2.1 (± 2.1); and pain, 1.9 (± 2.3). Compared to the index population in which the FSFI cut-score was validated (healthy women ages 18-74), all scores were low. Compared to published scores of a postmenopausal population, scores were not statistically different. Multivariate analysis isolated factors associated with lower FSFI scores, including having laparotomy as opposed to minimally invasive surgery (effect size, -7.1 points; 95% CI, -11.2 to -3.1; P<.001), lack of vaginal lubricant use (effect size, -4.4 points; 95% CI, -8.7 to -0.2, P=.040), and short time interval (<6 months) from hysterectomy to questionnaire completion (effect size, -4.6 points; 95% CI, -9.3-0.2; P=.059).
  
  
  CONCLUSIONS
  The rate of SD, as defined by an FSFI score <26, was prevalent. The postmenopausal status of EC patients alone is a known risk factor for SD. Additional factors associated with poor sexual functioning following treatment for EC included receipt of laparotomy and lack of vaginal lubricant use.
authors.affiliation: Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. shari.damast@yale.edu
authors.forename: Shari
authors.initials: S
authors.lastname: Damast
authors.forename: Kaled M
authors.initials: KM
authors.lastname: Alektiar
authors.forename: Shari
authors.initials: S
authors.lastname: Goldfarb
authors.forename: Anne
authors.initials: A
authors.lastname: Eaton
authors.forename: Sujata
authors.initials: S
authors.lastname: Patil
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Mosenkis
authors.forename: Antonia
authors.initials: A
authors.lastname: Bennett
authors.forename: Thomas
authors.initials: T
authors.lastname: Atkinson
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Jewell
authors.forename: Mario
authors.initials: M
authors.lastname: Leitao
authors.forename: Richard
authors.initials: R
authors.lastname: Barakat
authors.forename: Jeanne
authors.initials: J
authors.lastname: Carter
authors.forename: Ethan
authors.initials: E
authors.lastname: Basch
mesh_terms: D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D003430:Cross-Sectional Studies; D003681:Dehydration / Q000209:etiology; D004106:Dilatation / Q000295:instrumentation / Q000706:statistics & numerical data; D016889:Endometrial Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007813:Laparotomy / Q000009:adverse effects; D007989:Libido / Q000502:physiology; D008875:Middle Aged; D009948:Orgasm / Q000502:physiology; D010146:Pain / Q000209:etiology; D010549:Personal Satisfaction; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods; D012016:Reference Values; D012044:Regression Analysis; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014622:Vaginal Creams, Foams, and Jellies / Q000008:administration & dosage; D014623:Vaginal Diseases / Q000209:etiology; D055815:Young Adult
chemical_list: D014622:Vaginal Creams, Foams, and Jellies