Considering symptom burden and social relationships during sexual health management in ovarian suppression-treated women with breast cancer

BACKGROUND: Ovarian function suppression (OFS) treatment induces sudden menopause in women with breast cancer, leading to severe sexual issues. While overall sexual health research is limited, evidence specific to OFS-treated women is even scarcer. We aim to compare the symptom burden and interpersonal relationships of sexually active (SAW) and inactive women (SIW). METHODS: A cross-sectional study was conducted from October 2023 to July 2024. Participants completed questionnaires including demographic/clinical data and scales assessing symptom burden, social support, and social alienation. Convenience sampling included 1134 OFS women (SIW, n = 339; SAW, n = 795). RESULTS: Before and after overlap weighting (OW), SIW is consistently associated with higher overall symptom burden; post-OW, it correlates only with phase-specific poorer social attributes. Initially, a lower 'lost interest in sex' burden correlates with SIW, but this relationship reverses after adjustment. Following OW, anxiety (OR 6.32, 95%CI 1.33-29.97), mood swings (OR 3.84, 95% CI 1.05-14.12), and depression (OR 2.39, 95%CI 1.00-5.69) show the highest odds of occurrence in SIW vs. SAW. Relative to "Independent & Balanced", married SIW treated for 1-3 months align with "Isolated & Overburdened". Conversely, SAW profiles vary: married women treated for 3-5 years belong to "Selective Sexual Burden," married women belong to the "Latently Stressed", while those treated for 1-3 months fall into "Vaginal Symptom-Focused" or "Multi-System Diffuse Distress". CONCLUSIONS: Sex life is associated with OFS women's physical, mental, and interpersonal burdens. We identified SIW/SAW phenotyping categories with different symptom and interpersonal burdens and women with different social support sensitivities, providing a theoretical basis for future interventions.