Menopausal Symptoms and Sexual Functioning
Menopausal symptoms and sexual dysfunction are common in breast cancer survivors. To date, most breast cancer survivors included in evaluations of sexual dysfunction have been over age 40, reflecting the demographics of breast cancer. Little information is available focusing on sexual dysfunction in very young breast cancer survivors, and no intervention studies have been conducted. Research has, however, identified risk factors for sexual dysfunction in breast cancer survivors including younger age, premature menopause, and the use of chemotherapy (124). The use of tamoxifen and type of breast surgery may also have an impact on sexual functioning, especially in young breast cancer survivors. In a survey of 371 women diagnosed with breast cancer age 40 and younger (mean age at diagnosis 33 years and mean age at follow-up 36 years) where 77% of these women were premenopausal at follow-up, many reported bothersome sexual functioning or menopausal-type symptoms (125). In particular, 46% of women reported hot flashes and 39% reported dyspareunia. Current ovarian suppression, menopausal status, baseline anxiety before the diagnosis, pregnancy after the diagnosis, prior chemotherapy, and lower perceived financial status were associated with more bothersome symptoms. Evidence indicates that intervention to improve menopausal symptoms and sexual functioning is effective, although limited research to date focuses on very young women (126).