Impact of Chemotherapy on Sexual Dysfunction in Turkish Women with Breast Cancer: A Single-Center Prospective Cohort Study

Abstract

Although numerous studies have explored the connection between breast cancer surgery and sexual function, research on chemotherapy's temporal effects is limited. Addressing the impact of chemotherapy on sexual dysfunction is critical for improving quality of life. The aim of this study is to investigate changes in sexual function before, during, and after chemotherapy treatment, with a focus on asSociated factors. A total of 101 sexually active, reproductive-aged women diagnosed with locally advanced breast cancer were included in the study. The sexual dysfunction was evaluated by using the female sexual function index (FSFI) across 3 treatment phases: before, during, and after chemotherapy. Covariates such as age, baseline sexual dysfunction, tumor localization, comorbidity, family history of cancer, and receptor-related factors were analyzed for their influence on score changes during specific periods. A mixed-effects model was employed to evaluate asSociations and interactions between these variables and sexual function outcomes. Sexual function scores significantly declined across treatment phases. Notable reductions were observed in desire (P < .001), arousal (P < .001), lubrication (P < .001), orgasm (P < .01), and satisfaction (P < .01), while pain scores increased (P < .01). Total FSFI scores significantly dropped during and after chemotherapy (P < .001 and P < .01, respectively). Patients with preexisting sexual dysfunction experienced significantly greater declines in desire, lubrication, and satisfaction, along with more pronounced increases in pain-related discomfort scores, particularly in the FSFI pain subscale (P < .01). Older age, comorbidity, and tumor localization were significantly asSociated with worsening sexual function, whereas receptor status and histopathology showed no meaningful effect. Our findings confirm a high prevalence of sexual dysfunction among women with breast cancer. These results highlight the multifaceted impact of chemotherapy on sexual function and reveal a clear temporal pattern of changes across treatment phases.