Effect of tamoxifen on sexual functioning in patients with breast cancer

Purpose: To define the incidence of sexual dysfunction in a population of w omen with breast cancer treated with tamoxifen. Patients and Methods: Breast cancer patients with a performance states of 0 to 2 who had been treated with tamoxifen for 2 to 24 months completed the following measures: the Center for Epidemiologic Studies-Depression Scale, the Sexual History Form, and the Breast Cancer Prevention Trial Symptom Che cklist. Forty-nine of the participants underwent gynecologic examinations w ith vaginal smears for determination of estrogen effect. Results: Fifty-seven women were entered onto the trial. Sexual desire, arou sal, and ability to achieve orgasm were comparable to norms established in participants in the Tamoxifen Prevention Trial (National Surgical Adjuvant Breast and Bowel Project P-01), Pain, burning, or discomfort with intercour se war reported in 54% of patients and did not correlate with age, surgical treatment of the primary cancer, or chemotherapy. Estrogen effect was seen on the vaginal smears of 34 of 49 participants and war more common in olde r patients (P =.054). The presence of estrogen effect correlated with negat ive reactions during sex(P =.02) and vaginal dryness or tightness (P =.046) . Conclusion: Women treated with tamoxifen in the adjuvant setting experience d symptoms of sexual dysfunction. The individual contributions of chemother apy and tamoxifen to sexual dysfunction warrant prospective study. J Clin O ncol 17:1488-1492, (C) 1999 by American Society of Clinical Oncology.