Aims: The negative impact of adjuvant endocrine therapy on genitourinary symptoms in postmenopausal women with early breast cancer has been underestimated in clinical trials, limiting our understanding of the prevalence and severity of symptoms in these women.
Methods: A multi-center prospective questionnaire design was used to measure prevalence and severity of genitourinary symptoms, and their impact on sexual function and quality of life (QoL), in 177 participants before adjuvant endocrine therapy (baseline) and at 6-months.
Results: There was significant increase in prevalence of any incontinence (p=0.023), voiding (p=0.001) and vaginal symptoms (p=0.006) reported by participants over time. There was a trend in deterioration in symptom levels over time; increased severity was seen across 18 of the 29 symptoms assessed (62%). Urinary symptoms had a negative impact on household tasks (p=0.005), ability to travel (p=0.014) and fluid intake (p=0.038). Symptoms caused participants to feel worn out/tired (p=0.006), anxious (p=0.049) and bad about themselves (p=0.046). Partner relationships were challenged through deterioration in sexual function (p=0.005) and more sexual symptom bother (since baseline) (p=0.001). Worries about the vagina and vaginal symptoms significantly interfered with sex life (p=0.005). Impaired vaginal symptom-related QoL at follow-up was predicted by parity (OR:2.99), severe baseline incontinence (OR:1.12), voiding (OR:1.31) and storage symptoms (OR:1.24). Impaired urinary symptom-related QoL at follow-up by having one or more chronic diseases (OR:4.09), and severe baseline incontinence (OR:1.43).
Conclusions: Genitourinary symptoms are highly prevalent in this group, have a significant impact on QoL and sexual activity, and can be predicted by baseline characteristics. Results can inform clinical practice and lead to early recognition and appropriate symptom management.