Investigating the quality of sexual function in women with genital cancers: A structural equation analysis approach

Genital cancers significantly impair women's quality of life, with sexual dysfunction as a common yet under-addressed issue. Most studies use univariate analyses and lack a comprehensive model of the multifactorial influences on sexual function.

This study aimed to assess sexual function in women with genital cancers and model the relationships between influencing factors using structural equation modeling (SEM).

A cross-sectional analytical study design was conducted on 125 women aged 15-49 years with genital cancers (cervical, uterine, ovarian, or vaginal) attending oncology clinics in Tehran, Iran, from November 2019 to February 2020. Data were collected using a demographic questionnaire and the Female Sexual Function Index (FSFI). Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were performed using RStudio (version 4.6.3) software to examine direct and indirect effects and assess model fit RESULTS: Mean FSFI score was 20.04 ± 4.78, indicating moderate sexual dysfunction. Orgasm (β = 0.959) and lubrication (β = 0.839) were the strongest predictors; desire had the weakest effect (β = 0.237). Chemotherapy was significantly linked to lower sexual function compared to no treatment or radiotherapy (p-value< 0.05). Women with 2-3 children had lower scores than those with one child (p-value= 0.033), indicating a negative impact of parity. Age and duration of marriage showed no significant association. The SEM model fit well: CFI = 0.93, GFI = 0.95, RMSEA = 0.032.

Women with genital cancers experience moderate sexual dysfunction, primarily influenced by chemotherapy and higher parity. SEM provides a robust multivariate framework for understanding these relationships, supporting the need for patient-centered, multidisciplinary interventions to improve sexual health in survivors.