Sexual Functioning in Women with Breast Cancer: Role of Depression, Anxiety and Coping Styles

Abstract

: Sexual dysfunction encompasses a broad spectrum of issues, all of which are susceptible to insult after treatment for cancer. Sexual dysfunction affects up to 90% of women treated for breast cancer, and sexual quality of life is a significant concern for breast cancer survivors. This study investigated role of depression, anxiety and coping styles in developing sexual dysfunctions in 210 women with breast cancer, one year after diagnosis. The median age was 58. Female Sexual Functioning Index (FSFI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Coping Inventory for Stressful Situations (CISS) were used for this purpose. All women stated that before breast cancer they did not have significant sexual problems that would interfere with sexual pleasure. It is noticeable that women included in this study report high levels of pain and discomfort during and after vaginal penetration have low levels of sexual arousal and have significant difficulty achieving orgasm and lubrication, which is significantly associated with high levels of anxiety and moderate to high levels of depression. They are more likely to use a task-oriented coping strategy, and within avoidance as a coping strategy, they are more likely to use a distraction. More frequent use of avoidant strategies and less propensity for emotion-oriented strategies is associated with greater sexual desire. Women who used emotion-oriented coping strategies have more pronounced symptoms of depression and anxiety. Lower levels of overall sexual function were found in women who had a mastectomy (total and partial). Breast reconstruction after mastectomy has a positive influence on sexual functioning, especially on sexual arousal and pleasure, and women who have not had a mastectomy report greater sexual desire and arousal, and less pain during sexual intercourse. Participants who were not exposed to radiotherapy during treatment expressed greater satisfaction with achieving orgasms and lubrication during sexual intercourse. Hierarchical regression analysis indicated that depression, anxiety and coping styles significantly contribute to all domains of sexual functioning. These results add to growing evidence that sexual quality of life is a multidimensional construct with aspects differentially affected by variables related to cancer survivorship.