title: Risk factors for negative impacts on sexual activity and function in younger breast cancer survivors.
abstract: OBJECTIVE
  We aim to examine changes in sexual activity and function among younger breast cancer survivors who were sexually active before diagnosis and to investigate risk factors for negative impacts on them.
  
  
  METHODS
  An observational cohort study enrolled 304 premenopausal and sexually active women diagnosed with early stage breast cancer. Questionnaires were completed, and sexual activity was measured at two time points: after surgery, to assess sexual activity and function before diagnosis, and then at least 12 months after the completion of chemotherapy or endocrine therapy. For each domain of the Female Sexual Function Index, a score below 3 was classified as indicative of a sexual problem. Each sexual problem was considered to be dysfunctional if it was associated with distress.
  
  
  RESULTS
  The median age at the last survey was 46.0 years (range: 23-57). Of the participants, 35 (11.5%) became sexually inactive after treatment. Among the 269 women who remained sexually active, 31.6% were currently experiencing sexual dysfunction, which was significantly higher compared with the frequency before diagnosis. In the multivariate logistic regression model, chemo-related menopause, thyroid dysfunction, and depression were independent risk factors for sexual inactivity. Chemo-related menopause was a significant risk factor for sexual dysfunction.
  
  
  CONCLUSIONS
  Chemo-related menopause was significantly associated with both sexual inactivity and dysfunction after treatment. Thyroid dysfunction and depression were risk factors for sexual inactivity in younger breast cancer survivors.
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Maria
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, South Korea.
authors.forename: Yun Hwan
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Myung Jae
authors.initials: MJ
authors.lastname: Jeon
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology*; D015331:Cohort Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008593:Menopause / Q000523:psychology; D008875:Middle Aged; D012307:Risk Factors; D012725:Sexual Behavior / Q000502:physiology* / Q000523:psychology*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D013959:Thyroid Diseases / Q000523:psychology; D016896:Treatment Outcome; D055815:Young Adult