Sexual Health in Hematopoietic Stem Cell Transplantation Survivors

Sexual dysfunction is a common complication affecting the majority of hematopoietic stem cell transplant (HSCT) survivors. However, data on the relationships between sexual health domains, patient-reported quality of life (QoL), and psychological distress remain limited.

We conducted secondary data analyses of baseline data from 2 randomized sexual health intervention clinical trials involving HSCT survivors who were at least 3 months post-HSCT and reported sexual dysfunction causing distress between February 2019 and February 2023. We assessed sexual health domains (ie, global satisfaction with sex, interest, and function [PROMIS Sexual Function and Satisfaction Measure]), QoL (Functional Assessment of Cancer Therapy - Bone Marrow Transplant), and psychological distress (Hospital Anxiety and Depression Scale) at the time of enrollment. Separate multivariate regression analyses examined the relationships of sexual health domains with QoL and psychological distress.

Among the 185 enrolled patients (mean [SD] age, 54.8 [14.1] years), 88.1% identified as White, 35.1% identified as female, 83.2% were married or living with someone, and 93.5% identified as heterosexual/straight. Higher global satisfaction with sex was associated with better QoL (B = 0.988; P=.001) and lower depression (B = -0.119; P=.017) and anxiety symptoms (B = -0.124; P=.038). Higher patient-reported interest in sex was associated with better QoL (B = 2.651; P=.001) and lower depression symptoms (B = -0.387; P=.003). Sexual function domains were not associated with psychological distress or QoL, except for orgasm pleasure and erectile dysfunction (males only) (B = 0.277; P=.036), which was associated with QoL.

Satisfaction with sex and interest in sex, in contrast to sexual function domains, were associated with QoL and psychological distress in HSCT survivors. These findings underscore that supportive care interventions targeting satisfaction with and interest in sex may serve an important role in improving the QoL and psychological health in this population. Future longitudinal studies should examine causal pathways.