Effect of endocrine treatment on sexuality in premenopausal breast cancer patients: A prospective randomized study

Purpose: to study the sexual effects of the 2-year adjuvant goserelin (Zola dex [Zeneca AB, Sodertalje, Sweden]) alone, tamoxifen alone, and Zoladex an d tamoxifen in combination (ZT) versus no adjuvant endocrine therapy among premenopausal breast cancer patients with or without chemotherapy in a cont rolled clinical trial (a European multicenter trial: Zoladex in Premenopaus al Breast Cancer patients), Patients and Methods: This prospective study examined several aspects of se xuality through the vee of self-administered questionnaires, which were com pleted by patients at seven points of assessment for 3 years after randomis ation. Results: patients treated with chemotherapy had a higher level of sexual dy sfunction than did patients who received no systemic treatment. The additio n of endocrine treatment did not alter this result. In contrast, among pati ents who did not receive chemotherapy, Zaladex and TT produced a significan tly higher level of dysfunction from 1 to 2 years after inclusion, or compa red with there who received no endocrine treatment. Tamoxifen alone did not produce side effects, After termination of endocrine treatment, sexual dy function began to diminish, There with chemotherapy had high and frequently increasing levels of dysfunction even after 2 to 3 years of independent of endocrine treatment. Zoladex had a negative effect on sexual fear, which w ar reduced by the addition of tamoxifen, Conclusion: Zoladex increased sexual dysfunction during treatment among pat ients without chemotherapy, but the disturbances of sexual functioning were reversible, The use of adjuvant chemotherapy war associated with continued sexual problems, even at 3 years after randomisation.