Submitted June 19, 2007
Accepted September 1, 2007
Sexual function changes over the 5 years after high dose treatment and hematopoietic cell transplantation for malignancy, with case-matched controls at 5 years
Karen L Syrjala*, Brenda F Kurland, Janet R Abrams, Jean E Sanders, and Julia R Heiman
Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
Department of Medicine and Pediatrics, University of Washington School of Medicine, Seattle, WA, United States
Kinsey Institute for Research in Sex, Gender & Reproduction, & Depts of Psychology and Brain Sciences and Clinical Psychiatry, Indiana University, Bloomington, IN, United States
* Corresponding author; email: ksyrjala{at}fhcrc.org.
This prospective study evaluated sexual function through five years after myeloablative allogeneic hematopoietic cell transplantation (HCT) for cancer to determine sexual function recovery and residual problems. Adults completed measures before HCT (N=161), with survivors followed at six months and one, two, three and five years. At five years case-matched controls also completed assessments. Analyses indicated that males and females differed in rates of being sexually active across time (P<.001) and in overall sexual function (P<.001). Both genders declined in sexual activity rates and sexual function from pre-HCT to six months (P
.05). Activity rates recovered for males by one year (74%) and for females by two years (55%). Males improved from their six-month nadir in sexual function by two years (P=.02), whereas females did not improve by five years (P=.17). Both male and female survivors were below controls in rates of sexual activity and sexual function at five years. Most women reported sexual problems (80% of survivors vs. 61% of controls, P=.11); in contrast for men 46% of survivors vs. 21% of controls (P=.05) reported problems. Thus despite some recovery, sexual dysfunction remained a major problem for males and females after HCT. Aggressive efforts are needed to treat these deficits.
