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Partner status moderates the relationships between sexual problems and self-efficacy for managing sexual problems and psychosocial quality-of-life for postmenopausal breast cancer survivors taking adjuvant endocrine therapy

Dorfman, Caroline S. PhD1; Arthur, Sarah S. MA1; Kimmick, Gretchen G. MD1; Westbrook, Kelly W. MD2; Marcom, Paul Kelly MD2; Corbett, Cheyenne PhD3; Edmond, Sara N. PhD4,5; Shelby, Rebecca A. PhD1

doi: 10.1097/GME.0000000000001337
Original Articles

Objective: Past studies indicate that >90% of breast cancer survivors taking adjuvant endocrine therapy (AET) experience menopausal symptoms including sexual problems (eg, vaginal dryness, dyspareunia); however, research examining the impact of these problems on quality-of-life is limited. This cross-sectional study examined (1) the impact of sexual problems and self-efficacy for coping with sexual problems (sexual self-efficacy) on quality-of-life (ie, psychosocial quality-of-life and sexual satisfaction), and (2) partner status as a moderator of these relationships.

Methods: Postmenopausal breast cancer survivors taking AET completed measures of sexual problems (Menopause-Specific Quality-of-Life [MENQOL] sexual subscale], sexual self-efficacy, psychosocial quality-of-life (MENQOL psychosocial subscale), and sexual satisfaction (Functional Assessment of Cancer Therapy-General item).

Results: Bivariate analyses showed that women reporting greater sexual problems and lower sexual self-efficacy had poorer quality-of-life and less sexual satisfaction (all P-values < 0.05). Partner status moderated the relationship between sexual problems and psychosocial quality-of-life (P = 0.02); at high levels of sexual problems, unpartnered women experienced poorer psychosocial quality-of-life than partnered women. Partner status also moderated the relationship between self-efficacy and psychosocial quality-of-life (P = 0.01). Self-efficacy was unrelated to psychosocial quality-of-life for partnered women; for unpartnered women, low self-efficacy was associated with poorer quality-of-life. Partner status did not moderate the relationships between sexual problems or self-efficacy with sexual satisfaction.

Conclusions: Greater sexual problems and lower sexual self-efficacy were associated with poorer psychosocial quality-of-life and sexual satisfaction among postmenopausal breast cancer survivors taking AET. Interventions to address sexual problems and sexual self-efficacy, particularly among unpartnered women, may be beneficial for improving the well-being of postmenopausal breast cancer survivors on AET.

1Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC

2Division of Medical Oncology, Duke University, Durham, NC

3Duke Supportive Care and Survivorship Center, Duke University, Durham, NC

4Pain Research, Informatics, Multimorbidity & Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT

5Department of Psychiatry, Yale School of Medicine, New Haven, CT.

Address correspondence to: Rebecca A. Shelby, PhD, 2200 W. Main St., Suite 340, Durham, NC 27705. E-mail:

Received 25 January, 2019

Revised 25 February, 2019

Accepted 25 February, 2019

Funding/support: K07CA138767.

Financial disclosure/conflicts of interest: None reported.

An abstract presenting this work was previously presented. The citation is listed below: Dorfman, C.S., Arthur, S.S., Kimmick, G., Westbrook, K., Marcom, K., Edmond, S.N., Shelby, R.A. (September 2018). Partner Status Moderates the Relationship between Sexual Problems and Self-efficacy for Managing Sexual Problems and Psychosocial Quality-of-Life for Breast Cancer Survivors taking Adjuvant Endocrine Therapy. Poster presented at the 6th Conference of the Scientific Network on Female Sexual Health and Cancer, Durham, NC.

Online date: April 15, 2019

© 2019 by The North American Menopause Society.