title: Satisfaction with sex life in sexually active heterosexual couples dealing with breast cancer: a nationwide longitudinal study.
abstract: BACKGROUND
  A breast cancer (BC) diagnosis can profoundly affect the sex life of patient and partner within a couple. The purpose of the present study is to examine whether individual and partner sexual functioning, affectionate behavior, emotional closeness and depressive symptoms are associated with change over time in satisfaction with sex life of sexually active heterosexual couples dealing with BC and to explore whether the associations differ between patients and partners after adjustment for basic sociodemographic characteristics, comorbidity and BC treatment.
  
  
  METHODS
  Women with BC and their male partners participated in a longitudinal study (Time 1, ≤4 months after surgery; Time 2, 5 months later). Participants completed items from the PROMIS®Sexual Function and Satisfaction measure (version 1.0), two items measuring affectionate behavior, a single item measuring emotional closeness and the Center for Epidemiologic Studies-Depression Scale. Registers provided sociodemographic and medical information. Multilevel models were used, which take the interdependency of couples' scores into account.
  
  
  RESULTS
  A total of 287 sexually active couples were included in the analyses. Less vaginal discomfort and more vaginal lubrication were associated with increases in patients' satisfaction with sex life. Patients' and partners' satisfaction increased with higher ratings of their own orgasm ability and of partners' timing of ejaculation. Patients' reports of affectionate behavior were positively associated with their partners' satisfaction, and vice versa for partners. Patients' satisfaction increased the more emotional closeness their partner experienced. Partners' depressive symptoms were negatively associated with their satisfaction. Sociodemographic factors and BC treatment were not significantly associated with change in satisfaction.
  
  
  CONCLUSIONS
  Satisfaction with sex life in sexually active couples dealing with BC needs to be seen as a couple issue. Health professionals should take the partner into account when addressing sexuality issues. Couples' functioning and relationship-related factors may be promising targets for couple interventions.
authors.affiliation: a Unit of Medical Psychology, Department of Psychology , University of Southern Denmark , Odense , Denmark.|b National Research Center for Cancer Rehabilitation, Research Unit of General Practice, Department of Public Health , University of Southern Denmark , Odense , Denmark.
authors.forename: Nina
authors.initials: N
authors.lastname: Rottmann
authors.affiliation: b National Research Center for Cancer Rehabilitation, Research Unit of General Practice, Department of Public Health , University of Southern Denmark , Odense , Denmark.
authors.forename: Dorte
authors.initials: D
authors.lastname: Gilså Hansen
authors.affiliation: c Research Unit of General Practice, Department of Public Health , University of Southern Denmark , Odense , Denmark.
authors.forename: René
authors.initials: R
authors.lastname: dePont Christensen
authors.affiliation: d Health Sciences/Health Psychology , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands.
authors.forename: Mariët
authors.initials: M
authors.lastname: Hagedoorn
authors.affiliation: e Department of Epidemiology Research , Statens Serum Institut , Copenhagen , Denmark.|f Center for Sexology Research, Aalborg University , Aalborg , Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Frisch
authors.affiliation: g Center for Quality, Region of Southern Denmark , Middelfart , Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Nicolaisen
authors.affiliation: h Department of Breast Surgery , PBB, Rigshospitalet, University of Copenhagen , Copenhagen , Denmark.|i Danish Breast Cancer Group, Rigshospitalet , Copenhagen , Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Kroman
authors.affiliation: j Department of Breast Surgery , Herlev Hospital, University of Copenhagen , Herlev , Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Flyger
authors.affiliation: k Oncology Department , Finsen Center, Rigshospitalet, University of Copenhagen , Copenhagen , Denmark.|l Unit of Survivorship , Danish Cancer Society Research Center , Copenhagen , Denmark.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology*; D003863:Depression / Q000523:psychology; D004644:Emotions; D005260:Female; D020010:Heterosexuality; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D012725:Sexual Behavior