Prevalence and Determinants of Female Sexual Dysfunction, and Its Association With Neurotrophic Biomarkers in Gynaecological Cancer Survivors: A Cross-Sectional Study.

Abstract

IntroductionFemale sexual dysfunction (FSD) in any gynaecological cancer survivor is one aspect of female functioning that is neglected in survivorship care. Therefore, their actual prevalence is far from known to the treating physician. This study aimed to evaluate the prevalence of sexual dysfunction in gynaecological cancer survivors, determine its risk factors, and correlate sexual dysfunction with serum neurotropic factors.MethodsThis was a cross-sectional, observational study among 200 gynaecological cancer survivors who are sexually active, conducted in the gynaecological cancer clinic at a tertiary care centre. Sexual function was assessed using the Hindi-validated Female Sexual Function Index (FSFI), and serum brain-derived neurotrophic factor (BDNF), substance P, and neuropeptide Y (NPY) were measured by ELISA. The correlation between these biomarkers, with domains and subdomains of the female sexual function index, was explored.ResultsIn this cohort of 200 gynaecological cancer survivors, 189 (94.5%) women had FSD (FSFI <26.55). Age was the only independent clinical predictor of FSD in multivariable analysis (p = 0.02), while cancer site, stage, treatment modality, and menopausal status were not significant in this cohort. Overall biomarker levels did not differ between women with and without FSD. However, subdomain analysis showed high dysfunction rates in lubrication, orgasm, pain, and arousal, with significant biomarker differences for substance P and NPY in several dysfunctional subdomains.ConclusionsFSD was highly prevalent in gynaecological cancer survivors. While overall biomarker differences were not significant, subdomain-specific associations suggest that substance P and NPY may have a role in domain-level sexual dysfunction and merit further study.