title: Sexual problems during the first 2 years of adjuvant treatment with aromatase inhibitors.
abstract: BACKGROUND
  Sexual dysfunction has only recently been recognized as a highly prevalent side effect of adjuvant aromatase inhibitor (AI) therapy for breast cancer.
  
  
  OBJECTIVE
  A cross-sectional survey using standardized measures of female sexual function was designed to provide a detailed view of sexual problems during the first 2 years of adjuvant AI therapy and secondarily to examine whether sexual dysfunction leads to nonadherence to this therapy.
  
  
  METHODS
  Questionnaires were mailed to all 296 women in a breast oncology registry who had been prescribed a first-time AI for localized breast cancer 18-24 months previously.
  
  
  METHODS
  Items assessed medication adherence, demographic, and medical information. Scales included the Female Sexual Function Index, the Menopausal Sexual Interest Questionnaire, the Female Sexual Distress Scale-Revised, the Breast Cancer Prevention Trial Eight Symptom Scale to assess menopausal symptoms, and the Merck Adherence Estimator(®) .
  
  
  RESULTS
  Questionnaires were returned by 129 of 296 eligible women (43.6%). Respondents were 81% non-Hispanic white with a mean age of 63 and 48% had at least a college degree. Only 15.5% were nonadherent. Ninety-three percent of women scored as dysfunctional on the Female Sexual Function Index, and 75% of dysfunctional women were distressed about sexual problems. Although only 52% of women were sexually active when starting their AI, 79% of this group developed a new sexual problem. Fifty-two percent took action to resolve it, including 24% who stopped partner sex, 13% who changed hormone therapies, and 6% who began a vaginal estrogen. Scores on the Adherence Estimator (beliefs about efficacy, value, and cost of medication) were significantly associated with adherence (P = 0.0301) but sexual function was not.
  
  
  CONCLUSIONS
  The great majority of women taking AIs have sexual dysfunction that is distressing and difficult to resolve. Most continue their AI therapy, but a large minority cease sexual activity.
authors.affiliation: Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Leslie R
authors.initials: LR
authors.lastname: Schover
authors.forename: George P
authors.initials: GP
authors.lastname: Baum
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Fuson
authors.forename: Abenaa
authors.initials: A
authors.lastname: Brewster
authors.forename: Amal
authors.initials: A
authors.lastname: Melhem-Bertrandt
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001007:Anxiety / Q000139:chemically induced; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D055118:Medication Adherence; D008875:Middle Aged; D017060:Patient Satisfaction; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced*; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced*; D011795:Surveys and Questionnaires
chemical_list: D000276:Adjuvants, Immunologic; D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors
keywords: Aromatase Inhibitor; Breast Cancer; Medication Adherence; Sexual Dysfunction