Impact of pelvic radiotherapy on female sexuality

To assess physical and psychological morbidity, sexual functioning and social and relationship satisfaction among women treated with pelvic radiotherapy.

Observational (case-control) study of 199 women: 98 submitted to pelvic radiotherapy for the treatment of uterine, rectal or anal cancers and 101 without a personal history of cancer and similar socio-demographic variables. These completed a socio-demographic and clinical questionnaire, and validated measures of psychological health (DASS: Lovibond and Lovibond in Behav Res Ther 33:353-343, 1995), sexual function (FSFI: Rosen et al. in J Sex Marital Ther 26:191-208, 2007), social support (ESSS: Ribeiro in Analise Psicologica 3:547-558, 1999) and relationship satisfaction (IMS: Hudson in The WALMYR assessment scales scoring manual 1992).

Women submitted to pelvic irradiation reported a higher rate of adverse physical symptoms in the last month: fatigue 59 versus 25% (p < 0.001), lack of strength 42 versus 20% (p = 0.001), diarrhoea 24 versus 12% (p = 0.032), vaginal discharge 17 versus 7% (p = 0.024), skin erythema 9 versus 2% (p = 0.026). Levels of depression, anxiety and stress were higher among radiotherapy patients, but only reach statistical significance for the stress parameter (6.1 vs. 4.0, p = 0.012). Also these women reported lower scores of satisfaction with social support (57.2 vs. 62.2, p = 0.005) and sexual function (8.5 vs. 13.5, p = 0.049). No statistically significant differences occurred between the two groups regarding scores of relationship satisfaction (20.8 vs. 19.9, p = n.s.).

Our results suggested that pelvic radiotherapy had a negative impact on female sexuality. Thus, interventions that would help to reduce this impact need to be designed and integrated into routine clinical practice.