Aims: To determine the prevalence of sexual inactivity in female cancer survivors seeking treatment for menopausal symptoms, and to assess the role of vaginal dryness and pain in sexual inactivity.
Methods: Data were collected for all first visits to the Menopause Symptoms After Cancer (MSAC) clinic of the King Edward Hospital, from 2003-2010. Participants completed the Fallowfield Sexual Activity Questionnaire (SAQ), to report current sexual activity status and, for inactive women, reasons for inactivity. Participants also reported severity of vaginal and sexual symptoms (vaginal dryness, itching/irritation, bleeding/spotting, discharge; loss of interest in sex; pain or discomfort with intercourse; sexual dissatisfaction) with the Functional Assessment of Cancer Therapy (FACT) Scales.
Results: Of 428 women who completed the SAQ, 179 (42%) were not sexually active. The most common reasons for inactivity were lacking interest in sex (n=95, 53%), not having a partner (n=73, 41%), being too tired (n=59, 33%), and having a physical problem making sexual relations difficult or uncomfortable (n=37, 21%). Among sexually inactive women, severe vaginal dryness and pain with intercourse were more common among those who listed a physical problem as a reason for their inactivity than those who did not (dryness: n=21, 60% v. n=27, 20%, p=0.015; pain with intercourse: n=19, 59% v. n=16, 16%, p<0.001). Other vaginal symptoms did not differ. Severe loss of interest in sex and sexual dissatisfaction were more common among those who attributed inactivity to a physical problem than those who did not but differences did not reach statistical significance (loss of interest: n=22, 65% v. n=59, 47%, p=0.07; dissatisfaction: n=28, 85% v. n=80, 70%, p=0.09).
Conclusions: In this population, inactivity due to physical problems is related to vaginal dryness and pain with intercourse. Many sexually inactive women, irrespective of the reason, are dissatisfied with their sexual lives.