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Vaginal development and sexual functioning in young women after stem cell transplantation, chemotherapy, and/or radiotherapy for childhood hematological diseases

Bone Marrow Transplantation volume 53, pages 1157–1164 (2018)Cite this article

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Abstract

To study vaginal development and sexual functioning in young women after childhood hemopoietic stem cell transplantation (HSCT) and radio/chemotherapy. Observational case–control study on 30 young sexually active women survived after HSCT and/or radio/chemotherapy for childhood malignancies or hematologic diseases and 48 controls matched for age. Female Sexual Function Index was lower (median 24.05, IQR = 17.30–28.30 vs. 29.00, IQR = 25.30–31.40, p = 0.001), Female Sexual Distress Scale higher (median 16.00, IQR = 8.00–23.00 vs. 2.00, IQR = 0.00–4.00, p < 0.001), vaginal length shorter (mean difference = 21.1 mm; 95% CI = 19.3–23, p < .001) and vaginal maturation index worst in cases than in controls. Subjects treated by irradiation before HSCT had lower FSFI (median 21.85, IQR = 9.60–31.10 vs. 24.90, IQR = 17.30–28.30) and shorter vaginal length (median 45.55, IQR = 42.60–45.80 vs. 50.10, IQR = 45.30–52.90) compared to those who had not received conditioning treatment (p-values = 0.004 and p = 0.05, respectively). Compared to untreated subjects, women receiving hormonal replacement therapy had higher overall FSFI (p = 0.02), lower FSDS (0.04), and better VMI. Gonadotoxic therapies have adverse effects on vaginal development, sexual functioning, and distress in young females. Hormonal replacement therapy should be shortly considered after main gonodatoxic treatments to improve vaginal and sex health.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, IRCCS San Matteo Hospital, Pavia, Italy

    Fausta Beneventi, Elena Locatelli, Margherita Simonetta, Chiara Cavagnoli, Camilla Bellingeri, Irene De Maggio, Beatrice Ruspini & Arsenio Spinillo

  2. Department of Pathology, IRCCS San Matteo Hospital, Pavia, Italy

    Raffaella Pampuri

  3. Department of Pediatric Oncohematology, IRCCS San Matteo Hospital, Pavia, Italy

    Santina Recupero & Giovanna Giorgiani

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  1. Fausta Beneventi
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Correspondence to Elena Locatelli.

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Beneventi, F., Locatelli, E., Simonetta, M. et al. Vaginal development and sexual functioning in young women after stem cell transplantation, chemotherapy, and/or radiotherapy for childhood hematological diseases. Bone Marrow Transplant 53, 1157–1164 (2018). https://doi.org/10.1038/s41409-018-0149-x

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