The Association between Sexual Satisfaction and Interest with Quality of Life and Psychological Distress in Hematopoietic Stem Cell Transplant Recipients

Background Treatment-related sexual dysfunction affects the majority of hematopoietic stem cell transplant (HSCT) survivors. Data regarding the relationship between sexual health domains and patient-reported quality of life (QOL) and psychological distress are limited, particularly in this population. Methods We conducted a secondary analysis of a cross-sectional study that included 125 autologous and allogeneic HSCT survivors. All were at least 3 months post-HSCT and endorsed sexual dysfunction causing distress. This was based on the two-question approach from the 2015 National Comprehensive Cancer Network (NCCN) survivorship guidelines assessing 1) problems with sexual functioning and 2) whether these problems were causing distress. We assessed global satisfaction with sex and interest in sex (PROMIS), QOL (Functional Assessment of Cancer Therapy-Bone Marrow Transplant [FACT-BMT]), and psychological distress (Hospital Anxiety and Depression-Scale [HADS]). We used multivariate regression analyses, adjusting for age, race, and gender, to examine the association between the sexual health domains with QOL and psychological distress. Results Study participants had a median age of 55.0 (SD 14), and the majority were male (67.2%; 84/125). Female sex was associated with lower global satisfaction with sex (B= -2.14, P=0.019) and lower interest in sex (B= - 1.69, P<0.001). In multivariable regression analyses, global satisfaction with sex was associated with better QOL (B=0.86, P=0.015) but not with depression (B= -0.12, P=0.056) or anxiety (B= -0.10, P=0.180) symptoms. Patient's interest in sex was associated with their QOL (B=3.28, P<0.001), depression (B= -0.51, P=0.002), and anxiety (B= -0.39, P=0.032) symptoms. Conclusions Sexual health domains including global satisfaction with sex and interest in sex were associated with QOL and psychological distress at baseline in HSCT survivors. These findings underscore the need for supportive care interventions to improve sexual satisfaction and interest in this population.