Impact of Castration on the Sexual Life in Young Women at the National Institute of Oncology of Rabat, Morocco

Introduction: Castration, also referred to as hormonal suppression, is generally understood as the halt of hormone production by the ovaries in premenopausal women. This can occur through medical means, such as the administration of LH-RH agonists or antagonists that act reversibly on the hypothalamic- pituitary axis, or through surgical or radical methods that permanently eliminate hormonal production. Castration is primarily recommended for premenopausal women with hormone receptor-positive breast cancer. Regardless of the approach used, it produces side effects akin to those experienced during menopause, including hot flashes, anxiety, depressive disorders, and trophic changes that may affect sexual function. Thus, our study seeks to investigate the effects of castration on sexual life in our patients undergoing treatment for hormone receptor-positive breast cancer. Materials and Methods: This study was carried out at a day hospital to assess the effects of mainly medical, but also surgical and radical castration on couple dynamics in 50 patients, averaging 40 years of age, who are being treated for hormone receptor-positive breast cancer, regardless of whether it is localized or metastatic. Results: The majority of patients report experiencing side effects associated with castration, especially hot flashes, which affect nearly all patients, as well as depressive and anxiety disorders. However, it remains challenging to determine whether these issues are directly linked to the disease or its treatment. Additionally, many patients face sexual disturbances, including decreased libido and vaginal dryness, which significantly impact couple dynamics in almost 50% of cases. Conclusion: Investigating the effects of castration on sexuality, particularly regarding couple dynamics, highlights a significant yet sensitive topic. This issue, often considered taboo, represents a major side effect of prolonged treatment in long-term survivors. Therefore, it is essential to engage in regular discussions and collaborate with specialists, especially sexologists, to enhance tolerance and achieve lasting improvements in quality of life.