Sexual dysfunction prior to high-dose chemotherapy and bone marrow transplantation

A number of studies have suggested that high-dose chemotherapy and bone marrow transplantation may be associated with a variety of abnormalities of psychological function including sexual dysfunction. However, few studies have prospectively evaluated the association between sexual dysfunction and BMT. In particular, there are very little baseline data about sexual function immediately before transplant. The sexual function of 30 patients was assessed immediately prior to high-dose chemotherapy and bone marrow transplantation using the Derogatis Interview for Sexual Functioning (DISF) for males and females. More than 80% of patients had hematological malignancies; more than half were allograft recipients. Forty-seven percent of patients were found to have global sexual dysfunction and 60% had abnormalities of at least one parameter of sexual function. Forty-seven percent were dissatisfied with their sex life. Sexual dysfunction was associated with ejaculatory problems (P < 0.02) and erectile problems (P = 0.06) but not with amenorrhea. There was an association between cancer-related psychological problems and sexual dysfunction. A control group of inpatients with cancer had a similar incidence of sexual dysfunction (53% vs 47%, P = NS) suggesting that the tumor and its therapy were the major reasons for the sexual problems and not the prospect of transplant per se. This study emphasizes the need for baseline (pre-BMT) studies of quality of life and psychological function in BMT patients. We conclude that sexual dysfunction is a common finding prior to BMT; whether intervention can reduce this problem requires further study.