ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025
More than just "vaginal dryness": sexual dysfunction correlates with genitourinary anatomy changes in female cancer survivors.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo correlate genitourinary exam (GU) findings to patient-reported sexual dysfunction in female cancer survivors.
methodsThis retrospective cohort study included female cancer patients seen at a South Florida sexual health after cancer program. GU anatomy abnormalities and patient-reported sexual dysfunction were evaluated by Adapted Vulvovaginal Exam Score (AVES) and the Female Sexual Function Index (FSFI), respectively. Multivariate analyses compared, FSFI scores between patients with AVES > 3 vs. 0-3, (AVES > 3 corresponds to more abnormal GU exam). Adjusted odds ratio (aOR) and 95% confidence intervals (95% CI) were calculated.
resultsAVES was calculated for 162 female patients treated between 2020-2022. Median age was 46; 57% were Hispanic, and 79% had breast cancer. Common symptoms included vaginal dryness (55%) and dyspareunia (45%). Of 108 women with FSFI scores, 97% met criteria for female sexual dysfunction (FSD). 23% were found to have vaginal stenosis, and 42% had a narrowed vaginal introitus. Those with AVES > 3 had significantly lower FSFI lubrication, orgasm, satisfaction, and pain domain scores. Any endocrine therapy use was associated with worse AVES scores (aOR 0.20, 95% CI 0.05-0.80, p = 0.024), an association strongest with aromatase inhibitor (AIs) use. Low satisfaction scores < 3.6 were nearly three times more likely to have abnormal GU exams (aOR = 2.81; 95% CI: 1.03-7.65; p = 0.044).
conclusionFSD in female cancer survivors is associated with previously unreported GU exam changes that can limit or prevent sexual activity through pain and worsened sexual satisfaction. Ongoing work evaluates targeted interventions to improve symptoms and quality of life for this growing survivor population.
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