Impact of LHRHa Therapy on Relationship Dynamics and Sexual Coercion in Premenopausal Breast Cancer Patients: A...

Background/Objectives: Luteinizing hormone-releasing hormone agonists (LHRHa) are widely used to induce ovarian suppression in premenopausal women with hormone receptor-positive breast cancer. Although effective, abrupt medical menopause may negatively affect sexual health and intimate partner interactions. Sexual coercion-ranging from manipulation to explicit pressure-remains an underrecognized psychosocial burden in oncology. This multicenter study aimed to evaluate the association between LHRHa therapy and sexual coercion, including relational dynamics measured through the Sexual Coercion in Intimate Relationships Scale (SCIRS). Methods: This cross-sectional study included 81 premenopausal breast cancer patients receiving endocrine therapy at three tertiary centers in Türkiye. Participants were categorized into tamoxifen monotherapy users (n = 39) and LHRHa users (n = 42). Sexual coercion was assessed using the validated Turkish SCIRS, which includes Resource Manipulation/Violence, Defection Threat, and Commitment Manipulation domains. Mann-Whitney U, Kruskal-Wallis, and ANCOVA analyses were performed, adjusting for age, treatment duration, surgery type, chemotherapy, radiotherapy, and education level. The study was ethically approved (2023-KAEK-148) and prospectively registered (NCT06840847). Results: LHRHa users demonstrated significantly higher SCIRS scores across all domains compared with non-users (RM/V: p = 0.039; DT: p = 0.001; CM: p < 0.001; Total: p = 0.004). ANCOVA confirmed LHRHa therapy as an independent predictor after adjusting for covariates (p = 0.001-0.006). The largest effect was observed in the Commitment Manipulation domain (partial η² = 0.177). Younger patients (≤ 36 years) reported significantly greater coercion exposure across all domains (p = 0.018-0.042). Conclusions: LHRHa therapy is associated with increased sexual coercion and strained relational dynamics in premenopausal breast cancer patients, particularly among younger women. These findings emphasize the need for routine sexual health assessment, confidential psychosocial screening, and age-sensitive supportive interventions in endocrine therapy management.