Sexual health of endometrial cancer survivors before and after a physical activity intervention: A retrospective cohort analysis

Abstract

Objective Sexual dysfunction is common in endometrial cancer survivors (ECS). Our group previously tested a six-month exercise intervention in ECS. We performed a secondary analysis to determine intervention's impact on sexual health. Methods We studied 100 post-treatment Stage I-IIIa sedentary ECS who participated in a non-controlled, single-arm, home-based exercise intervention utilizing telephone counseling, printed material, and pedometers. Quality-of-life and physical activity measures were collected at baseline and six months. Sexual function (SF) and sexual interest (SI) scores were extracted from the QLACS questionnaire. Results Baseline SF and SI were lower in survivors with less than a four-year college degree (P < 0.001). Baseline SI was higher in survivors who were married or living with a significant other (P = 0.012). No significant differences in SF or SI were observed based on obesity status, race, time since diagnosis, or treatment type. Post-intervention, mean SF score improved (P = 0.002), 51% of participants had improved SI, and 43% had improved SF. When controlled for age and time since diagnosis, a one-hour increase in weekly physical activity was associated with a 6.5% increased likelihood of improved SI (P = 0.04). Increased physical activity was not associated with improved SF. Conclusions Although causation cannot be determined in this study, the correlation between receipt of an exercise intervention and improved sexual health for ECS is a novel finding. This finding suggests a role for physical activity as a strategy to improve the sexual health of ECS, which our group is examining in a larger prospective study.

Body mass index and sexual function in women with gynaecological cancer

“…Our results are in line with a study done by Oldenburg et al, which showed that higher BMI was inversely associated with sexual/vaginal problems in endometrial cancer . However, Armbruster et al found no association between BMI and sexual function or sexual interest in endometrial cancer survivors at least 6 months after treatment . A recent study by this team reported an association between physical inactivity and poorer sexual functioning in ovarian cancer survivors; however, no association between BMI and sexual dysfunction was found .…”

“…29 However, Armbruster et al found no association between BMI and sexual function or sexual interest in endometrial cancer survivors at least 6 months after treatment. 30 A recent study by this team reported an association between physical inactivity and poorer sexual functioning in ovarian cancer survivors; however, no association between BMI and sexual dysfunction was found. 31 For vulvar and cervical cancer, the literature is scarce, and the link between BMI and sexual functioning is unclear.…”

Factors of sexual quality of life in gynaecological cancers: a systematic literature review

“…Nine studies established a link between relationship status and SQoL [ 28 , 30 , 32 , 34 , 36 , 37 , 40 – 42 ]. Single women (i.e., unmarried, not in a stable relationship or not living with a significant other) may feel more vulnerable in new relationships [ 41 ], be at risk of an impaired body image [ 28 ], and have higher rehabilitation needs [ 34 ].…”

“…According to Barlow et al [ 40 ], intimacy and relationship status are more closely linked to sexual satisfaction than physical arousal. Not surprisingly, relationship status was associated with sexual activity [ 28 , 42 ] and it is also a predictor of sexual function and sexual interest [ 32 , 37 ]. Finally, Pinar et al [ 30 ] found that couples in an arranged marriage or those married for more than 30 years suffer from lower sexual interest and sexual dysfunction.…”

“…Our findings suggest that the SQoL of GCS varies across subgroups based on age, menopausal status, relationship status, and treatment modality (Table 2). To a lesser extent, variations in SQoL have been attributed to cancer site [27], tumour stage [28], BMI [29], education [30][31][32][33], and unemployment [30]. Due to space constraints, we will report only on the factors with the strongest evidence.…”