Before HCT, 61% of men and 37% of women were sexually active; the 3-year prevalence declined to 54% for men but increased to 52% for women.
Chronic GvHD in both sexes and TBI in men contribute to sexual dysfunction and dissatisfaction over the 3 years following HCT.
This prospective study described the trajectory of sexual well-being from before hematopoietic cell transplantation (HCT) to 3 years after in 131 allogeneic and 146 autologous HCT recipients and identified the predictors of post-HCT sexual dysfunction. Assessments were made pre-HCT, 6 months, 1, 2, and 3 years post-HCT using the Derogatis Interview for Sexual Function-Self Report and Derogatis Global Sexual Satisfaction Index. Sixty-one percent of men and 37% of women were sexually active pre-HCT; the prevalence declined to 51% (P=.01) in men and increased to 48% (P=.02) in women at 3 years post-HCT. After HCT, sexual satisfaction declined in both sexes (P<.001), as did Orgasm (P=.002) and Drive/Relationship (P<.001) in men, but Sexual Cognition/Fantasy (P=.01) and Sexual Behavior/Experience (P=.01) improved in women. All sexual function domains were worse in women compared to men (P≤.001). Older age negatively impacted sexual function post-HCT in both sexes (P<.01). Chronic graft vs. host disease was associated with lower Sexual Cognition/Fantasy (P=.003) and Orgasm (P=.006) in men and Sexual Arousal (P=.05) and sexual satisfaction (P=.005) in women. All male sexual functions declined with exposure to total body irradiation (P<.05). Multidisciplinary interventional strategies are needed to help vulnerable sub-populations recover sexual quality of life after HCT.
- Submitted May 6, 2013.
- Accepted August 11, 2013.
- Copyright © 2005 American Society of Hematology