Sexual dysfunction in young adult cancer survivors tied to fatigue, worse sleep, severe pain

Female young adult cancer survivors (YACS) with sexual dysfunction show higher levels of fatigue, have worse sleep, and experience more frequent severe pain compared to those without sexual dysfunction, reports a study.

However, in a logistic model, fatigue but not sleep is significantly associated with a higher likelihood of sexual dysfunction.

A total of 164 young women (aged 18‒39 years) previously treated for paediatric cancer completed self-report measures on sexual function, fatigue, sleep, and pain through the prospective cohort study Project REACH. The authors assessed sexual function using the Female Sexual Function Index (FSFI-6) and classified participants as experiencing significant sexual dysfunction if they scored ≤19 on this measure.

Likewise, the participants completed the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and items adapted from the Brief Pain Inventory. Lower FACIT-F, higher PSQI, and higher pain scores indicated more impaired functioning.

The authors compared fatigue, sleep, and pain among participants with and without sexual dysfunction using t-tests. They also conducted logistic regression to assess the effects of fatigue, sleep, and pain on the likelihood that participants would have sexual dysfunction.

More than half (56 percent) of the participants had significant sexual dysfunction. Those with sexual dysfunction experienced significantly more severe fatigue (p<0.001), worse sleep (p=0.02), and more days of severe pain (p=0.006) than those without sexual dysfunction.

In the logistic regression model, more severe fatigue significantly correlated with a higher likelihood of having sexual dysfunction (odds ratio [OR], 0.93, 95 percent confidence interval [CI], 0.88‒0.98), as did frequent severe pain (OR, 2.49, 95 percent CI, 0.99‒6.28), but the latter only reached marginal significance (p=0.053).

On the other hand, sleep showed no significant association with sexual dysfunction in the model.

“Cancer treatment early in life contributes to a wide range of late effects such as sexual dysfunction, fatigue, sleep disturbances, and widespread pain,” the authors said.