The role of space in obstructing clinical sexual health education: A qualitative study on breast cancer patients’ perspectives on barriers to expressing sexual concerns

Author(s):  
Ni Gong ◽  
Yiheng Zhang ◽  
Rongfei Suo ◽  
Willa Dong ◽  
Wenjie Zou ◽  
...  

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24056-e24056
Author(s):  
Shari Beth Goldfarb ◽  
Sally Saban ◽  
Ashley Arkema ◽  
Sujata Patil ◽  
Jessica Flynn ◽  
...  

e24056 Background: Breast cancer and its treatment adversely impact sexual function and QoL. As more women become survivors, information is needed about vulvovaginal symptoms, sexual concerns and treatment options. Methods: An IRB Limited Waiver of Authorization was obtained to evaluate the medical records of 650 breast cancer patients with initial sexual medicine consults between 7/19/12 & 3/5/19. All women completed the Clinic Assessment form including a pelvic exam checklist, vulvovaginal tissue quality assessment (Vaginal Assessment Scale (VAS)/Vulvar Assessment Scale (VuAS) and sexual function measures (FSFI, PROMIS-SF) at initial visit and 56% (366/650) completed it at follow-up visits. R v3.6.1 was used to perform statistical analysis. Results: Women were categorized at initial consult as either postmenopausal (PM), pre/perimenopausal or menopausal from ovarian suppression (OS). Median age at initial consult was 52 (range 26 to 83) and median endocrine exposure ranged from 12 months on Tamoxifen only to 52 months on Tamoxifen followed by an AI. Of the total sample, 60% reported no confidence in future sexual activity and 68% reported pelvic pain with exam at initial consult. Improvements were seen at the first follow-up in confidence about intimacy and sexual health concerns (p < .001). Vulvovaginal symptoms (VAS/VuAS) and dilator and vulvovaginal moisturizer use (p < .001) also improved from baseline to follow-up 1. The women most likely to attend first follow-up appointments were OS (70%) and PM women on AIs (64%) who also reported worse symptoms at baseline compared to pre/perimenopausal women on Tamoxifen. At initial presentation, PM on AIs and OS had poor exam outcomes respectively: pH > 5 (92%; 83%), poor vaginal elasticity (19%; 13%), vaginal dryness (88%; 68%), decreased rugosity (36%; 30%) and poor vascularity (33%; 21%). At initial consult, exam findings for pH, moisture, vulvar and vestibular irritation each correlated significantly with patient reported vaginal (VAS total score) and vulvar (VuAS total score) symptoms (p≤ .05). Conclusions: Breast cancer patients can benefit from coordinated multidisciplinary care addressing the long-term effects of premature menopause and endocrine therapy. Patient characteristics such as menopausal status and type/duration of endocrine therapy should be considered when assessing sexual health since aromatase inhibitors and ovarian suppression appear to worsen clinical exam and patient reported outcomes. Sexual health counseling and treatment can help women cope with sexual concerns during and after breast cancer therapy.





Author(s):  
Partha Basu ◽  
Richa Tripathi ◽  
Ravi Mehrotra ◽  
Koninika Ray ◽  
Anurag Srivastava ◽  
...  






2017 ◽  
Vol 22 (8) ◽  
pp. 918-924 ◽  
Author(s):  
Christine M. Gunn ◽  
Victoria A. Parker ◽  
Sharon M. Bak ◽  
Naomi Ko ◽  
Kerrie P. Nelson ◽  
...  


2016 ◽  
Vol 47 (4) ◽  
pp. 1721-1732 ◽  
Author(s):  
Hebatalla El Kassas ◽  
Maha Helal ◽  
Asmaa Abourabia ◽  
Naglaa Abd El Razik ◽  
Ahmed Farahat ◽  
...  


Author(s):  
M.L. Abouegylah ◽  
L.W. Salama ◽  
A. Mina ◽  
H.E. Sayegh ◽  
G. Naoum ◽  
...  


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