title: Sexual Activity and Function in Patients With Gynecological Malignancies After Completed Treatment.
abstract: OBJECTIVE
  Sexual activity (SA) and sexual function (SF) after completion of treatment are central for quality of life (QoL) in women affected by gynecological cancer (GC). The aim of this study was to analyze the sexual outcome and overall QoL of women after treatment for primary GC compared with a healthy control group (CG).
  
  
  METHODS
  In a multicenter cross-sectional study, 77 women aged 28 to 67 years were surveyed at least 12 months after completion of primary therapy for cervical, endometrial, or vulvar cancer [gynecological cancer group (GCG)]. Data were collected through validated questionnaires (Female Sexual Function Index-d, EORTC Quality of Life Questionnaire-C30, and Sexual Activity Questionnaire) and compared to a control of 60 healthy women (CG).
  
  
  RESULTS
  In the GCG, 41.3% were sexually active compared to 78.0% in the CG. Twelve women of the CG and 42 women of the GCG indicated the reasons for their sexual inactivity. The most common reason for sexual inactivity in the GCG was "the-presence-of-a-physical-problem" [18/42 (42.9%) vs 2/12 (16.7%) in the CG], whereas in the CG, "because-I-do-not-have-a-partner" was most common [6/12 (50.0%) vs 11/42 (26.2%) in the GCG]. Sexually active patients in the GCG had an SF comparable to the CG. In multivariate analysis of the total cohort (n = 137), relationship status [solid partnership vs living alone; odds ratio (OR), 33.82; 95% confidence interval (CI), 4.83-236.70], smoking (OR, 0.25; 95% CI, 0.06-1.03), and age (OR, 0.87; 95% CI, 0.79-0.94) influenced SA significantly. The probability of SA thereby decreased with increasing age. Quality of life and subjective general health status were not significantly different between the GCG and the CG (EORTC Quality of Life Questionnaire-C30 score 68.25 vs 69.67).
  
  
  CONCLUSIONS
  A high number of patients with GC remain sexually inactive after treatment, indicating that women experience persistent functional problems. However, women who regain SA after completed treatment have a good overall SF and vice versa.
authors.affiliation: *Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg; †Department of Gynecology and Gynecologic Oncology, University Hospital Freiburg, Freiburg; ‡Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Donata
authors.initials: D
authors.lastname: Grimm
authors.forename: Annette
authors.initials: A
authors.lastname: Hasenburg
authors.forename: Christine
authors.initials: C
authors.lastname: Eulenburg
authors.forename: Lisa
authors.initials: L
authors.lastname: Steinsiek
authors.forename: Sebastian
authors.initials: S
authors.lastname: Mayer
authors.forename: Stephanie
authors.initials: S
authors.lastname: Eltrop
authors.forename: Katharina
authors.initials: K
authors.lastname: Prieske
authors.forename: Fabian
authors.initials: F
authors.lastname: Trillsch
authors.forename: Sven
authors.initials: S
authors.lastname: Mahner
authors.forename: Linn
authors.initials: L
authors.lastname: Woelber
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D019529:Sexuality / Q000523:psychology*; D011795:Surveys and Questionnaires