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Satisfaction with sexual activity and sexual dysfunction in hematopoietic stem cell transplantation survivors and their partners: a couple study

Bone Marrow Transplantation volume 53, pages 967–976 (2018)Cite this article

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Abstract

Sexual dysfunction is a common long-term complication of hematopoietic stem cell transplantation (HSCT). We assessed the extent to which HSCT survivors and their partners agree on the importance of and satisfaction with sexual activity and causes of sexual dysfunction, using a cross-sectional survey. Ratings of the importance of sexual activity were significantly higher in survivors than those of partners (2.57 vs. 2.14, P < 0.01). More survivors (48.4%) tried to discuss about sexuality with their partners than partners themselves (23.1%, P < 0.01). Male survivors were more likely to be sexually active than female survivors (odds ratio [OR] 5.04, 95% CI 1.85, 13.74). While 23.3 and 38% of male survivors and partners reported “rejection of partners” as a cause of sexual dysfunction, only 13.3% and none of female partners and survivors pointed this as a cause of sexual dysfunction respectively. There was poor concordance between survivors and partners in attitudes toward sexuality, satisfaction with sexual activity, and causes of sexual dysfunction. Couples who considered adequate sexual activity important were more likely to be sexually active than those who did not (OR 5.53, 95% CI 1.18, 25.89). Our study highlights the need for providing information and counselling about sexuality both to survivors and partners.

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References

  1. Bhatia S. Long-term health impacts of hematopoietic stem cell transplantation inform recommendations for follow-up. Expert Rev Hematol. 2011;4:437–52.

    Article  Google Scholar 

  2. Socie G, Stone JV, Wingard JR, Weisdorf D, Henslee-Downey PJ, Bredeson C, et al. Long-term survival and late deaths after allogeneic bone marrow transplantation. Late Effects Working Committee of the International Bone Marrow Transplant Registry. New Engl J Med. 1999;341:14–21.

    Article  CAS  Google Scholar 

  3. Pidala J, Anasetti C, Jim H. Quality of life after allogeneic hematopoietic cell transplantation. Blood. 2009;114:7–19.

    Article  CAS  Google Scholar 

  4. Syrjala KL, Kurland BF, Abrams JR, Sanders JE, Heiman JR. Sexual function changes during the 5 years after high-dose treatment and hematopoietic cell transplantation for malignancy, with case-matched controls at 5 years. Blood. 2008;111:989–96.

    Article  CAS  Google Scholar 

  5. Wong FL, Francisco L, Togawa K, Bosworth A, Gonzales M, Hanby C, et al. Long-term recovery after hematopoietic cell transplantation: predictors of quality-of-life concerns. Blood. 2010;115:2508–19.

    Article  CAS  Google Scholar 

  6. Syrjala KL, Martin PJ, Lee SJ. Delivering care to long-term adult survivors of hematopoietic cell transplantation. J Clin Oncol. 2012;30:3746–51.

    Article  Google Scholar 

  7. Wong FL, Francisco L, Togawa K, Kim H, Bosworth A, Atencio L, et al. Longitudinal trajectory of sexual functioning after hematopoietic cell transplantation: impact of chronic graft-versus-host disease and total body irradiation. Blood. 2013;122:3973–81.

    Article  CAS  Google Scholar 

  8. Thygesen KH, Schjodt I, Jarden M. The impact of hematopoietic stem cell transplantation on sexuality: a systematic review of the literature. Bone Marrow Transplant. 2012;47:716–24.

    Article  CAS  Google Scholar 

  9. Yi JC, Syrjala KL. Sexuality after hematopoietic stem cell transplantation. Cancer J. 2009;15:57–64.

    Article  Google Scholar 

  10. Humphreys CT, Tallman B, Altmaier EM, Barnette V. Sexual functioning in patients undergoing bone marrow transplantation: a longitudinal study. Bone Marrow Transplant. 2007;39:491–6.

    Article  CAS  Google Scholar 

  11. Syrjala KL, Roth-Roemer SL, Abrams JR, Scanlan JM, Chapko MK, Visser S, et al. Prevalence and predictors of sexual dysfunction in long-term survivors of marrow transplantation. J Clin Oncol. 1998;16:3148–57.

    Article  CAS  Google Scholar 

  12. Tierney DK. Sexuality following hematopoietic cell transplantation. Clin J Oncol Nurs. 2004;8:43–7.

    PubMed  Google Scholar 

  13. Lara LA, De Andrade JM, Mauad LM, Ferrarese SR, Marana HR, Tiezzi DG, et al. Genital manifestation of graft-vs.-host disease: a series of case reports. J Sex Med. 2010;7:3216–25.

    Article  Google Scholar 

  14. Zantomio D, Grigg AP, MacGregor L, Panek-Hudson Y, Szer J, Ayton R. Female genital tract graft-versus-host disease: incidence, risk factors and recommendations for management. Bone Marrow Transplant. 2006;38:567–72.

    Article  CAS  Google Scholar 

  15. Janicsak H, Masszi T, Remenyi P, Ungvari GS, Gazdag G. Quality of life and its socio-demographic and psychological determinants after bone marrow transplantation. Eur J Haematol. 2013;91:135–40.

    Article  Google Scholar 

  16. Yucel D, Gassanov MA. Exploring actor and partner correlates of sexual satisfaction among married couples. Social Sci Res. 2010;39:725–38.

    Article  Google Scholar 

  17. Li Z, Mewawalla P, Stratton P, Yong AS, Shaw BE, Hashmi S, et al. Sexual health in hematopoietic stem cell transplant recipients. Cancer. 2015;121:4124–31.

    Article  Google Scholar 

  18. Norskov KH, Schmidt M, Jarden M. Patients’ experience of sexuality 1-year after allogeneic Haematopoietic Stem Cell Transplantation. Eur J Oncol Nurs. 2015;19:419–26.

    Article  Google Scholar 

  19. Flynn KE, Reese JB, Jeffery DD, Abernethy AP, Lin L, Shelby RA, et al. Patient experiences with communication about sex during and after treatment for cancer. Psychooncology. 2012;21:594–601.

    Article  Google Scholar 

  20. Reese JB. Coping with sexual concerns after cancer. Curr Opin Oncol. 2011;23:313–21.

    Article  Google Scholar 

  21. Bishop MM, Beaumont JL, Hahn EA, Cella D, Andrykowski MA, Brady MJ, et al. Late effects of cancer and hematopoietic stem-cell transplantation on spouses or partners compared with survivors and survivor-matched controls. J Clin Oncol. 2007;25:1403–11.

    Article  Google Scholar 

  22. Polomeni A, Lapusan S, Bompoint C, Rubio MT, Mohty M. The impact of allogeneic-hematopoietic stem cell transplantation on patients’ and close relatives’ quality of life and relationships. Eur J Oncol Nurs. 2016;21:248–56.

    Article  CAS  Google Scholar 

  23. Perz J, Ussher JM, Gilbert E. Feeling well and talking about sex: psycho-social predictors of sexual functioning after cancer. BMC Cancer. 2014;14:228.

    Article  Google Scholar 

  24. Wendt C. Perception and assessment of verbal and written information on sex and relationships after hematopoietic stem cell transplantation. J Cancer Educ. 2017;32:681-9.

  25. Hawkins Y, Ussher J, Gilbert E, Perz J, Sandoval M, Sundquist K. Changes in sexuality and intimacy after the diagnosis and treatment of cancer: the experience of partners in a sexual relationship with a person with cancer. Cancer Nurs. 2009;32:271–80.

    Article  Google Scholar 

  26. Alder J, Zanetti R, Wight E, Urech C, Fink N, Bitzer J. Sexual dysfunction after premenopausal stage I and II breast cancer: do androgens play a role? J Sex Med. 2008;5:1898–906.

    Article  Google Scholar 

  27. Gilbert E, Ussher JM, Perz J. Renegotiating sexuality and intimacy in the context of cancer: the experiences of carers. Arch Sex Behav. 2010;39:998–1009.

    Article  Google Scholar 

  28. Thirlaway K, Fallowfield L, Cuzick J. The Sexual Activity Questionnaire: a measure of women’s sexual functioning. Qual life Res. 1996;5:81–90.

    Article  CAS  Google Scholar 

  29. Molassiotis A, van den Akker OB, Milligan DW, Boughton BJ. Gonadal function and psychosexual adjustment in male long-term survivors of bone marrow transplantation. Bone Marrow Transplant. 1995;16:253–9.

    CAS  PubMed  Google Scholar 

  30. Stephenson KR, Meston CM. The young and the restless? Age as a moderator of the association between sexual desire and sexual distress in women. J Sex Marital Ther. 2012;38:445–57.

    Article  Google Scholar 

  31. Bober SL, Varela VS. Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol. 2012;30:3712–9.

    Article  Google Scholar 

  32. Jackson SE, Wardle J, Steptoe A, Fisher A. Sexuality after a cancer diagnosis: a population-based study. Cancer. 2016;122:3883–91.

    Article  Google Scholar 

  33. Ussher JM, Perz J, Gilbert E, Wong WK, Hobbs K. Renegotiating sex and intimacy after cancer: resisting the coital imperative. Cancer Nurs. 2013;36:454–62.

    Article  Google Scholar 

  34. Noerskov KH, Schjodt I, Syrjala KL, Jarden M. Sexual function 1-year after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant. 2016;51:833–40.

    Article  CAS  Google Scholar 

  35. Traa MJ, De Vries J, Bodenmann G, Den Oudsten BL. Dyadic coping and relationship functioning in couples coping with cancer: a systematic review. Br J Health Psychol. 2015;20:85–114.

    Article  Google Scholar 

  36. Park ER, Norris RL, Bober SL. Sexual health communication during cancer care: barriers and recommendations. Cancer J. 2009;15:74–7.

    Article  Google Scholar 

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Acknowledgements

The authors thank the HSCT survivors and their families participating in this study. They also thank staffs and community members of the Korea Blood Cancer Association.

Author contributions

JHJ conceived and designed the study and supervised the research; JC instructed the study protocol; JSK, S-SY, CHL, SP, SJK, KK, WSK, CWJ, and JHJ collected data; DK performed statistical analyses; KHY, DK, I-RK, E-KC, and HJC interpreted data; KHY and JC prepared a draft manuscript; All authors read and approved the final manuscript.

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    Authors and Affiliations

    1. Division of Hematology and Oncology, Department of Medicine,Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

      Kwai Han Yoo, Silvia Park, Seok Jin Kim, Kihyun Kim, Won Seog Kim, Chul Won Jung, Hye Jin Choi & Jun Ho Jang

    2. Division of Hematology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea

      Kwai Han Yoo

    3. Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea

      Danbee Kang & Juhee Cho

    4. Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

      Im-Ryung Kim, Eun-Kyung Choi & Juhee Cho

    5. Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

      Jin Seok Kim

    6. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea

      Sung-Soo Yoon

    7. Korea Blood Cancer Association, Seoul, South Korea

      Chul Hwan Lee

    8. Departments of Epidemiology and Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

      Juhee Cho

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    1. Kwai Han Yoo
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    Correspondence to Jun Ho Jang or Juhee Cho.

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    The authors declare that they have no conflict of interest.

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    Kwai Han Yoo and Danbee Kang contributed equally to this work.

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    Yoo, K.H., Kang, D., Kim, IR. et al. Satisfaction with sexual activity and sexual dysfunction in hematopoietic stem cell transplantation survivors and their partners: a couple study. Bone Marrow Transplant 53, 967–976 (2018). https://doi.org/10.1038/s41409-018-0097-5

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