Impact of pelvic radiotherapy on female sexuality

To assess physical and psychological morbidity, sexual functioning and social and relationship satisfaction among women treated with pelvic radiotherapy.

Observational (case–control) study of 199 women: 98 submitted to pelvic radiotherapy for the treatment of uterine, rectal or anal cancers and 101 without a personal history of cancer and similar socio-demographic variables. These completed a socio-demographic and clinical questionnaire, and validated measures of psychological health (DASS: Lovibond and Lovibond in Behav Res Ther 33:353–343, 1995), sexual function (FSFI: Rosen et al. in J Sex Marital Ther 26:191–208, 2007), social support (ESSS: Ribeiro in Analise Psicologica 3:547–558, 1999) and relationship satisfaction (IMS: Hudson in The WALMYR assessment scales scoring manual 1992).

Women submitted to pelvic irradiation reported a higher rate of adverse physical symptoms in the last month: fatigue 59 versus 25% (p < 0.001), lack of strength 42 versus 20% (p = 0.001), diarrhoea 24 versus 12% (p = 0.032), vaginal discharge 17 versus 7% (p = 0.024), skin erythema 9 versus 2% (p = 0.026). Levels of depression, anxiety and stress were higher among radiotherapy patients, but only reach statistical significance for the stress parameter (6.1 vs. 4.0, p = 0.012). Also these women reported lower scores of satisfaction with social support (57.2 vs. 62.2, p = 0.005) and sexual function (8.5 vs. 13.5, p = 0.049). No statistically significant differences occurred between the two groups regarding scores of relationship satisfaction (20.8 vs. 19.9, p = n.s.).

Our results suggested that pelvic radiotherapy had a negative impact on female sexuality. Thus, interventions that would help to reduce this impact need to be designed and integrated into routine clinical practice.