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年轻女性乳腺癌诊断后的性健康:患者和提供者的临床意义。

Sexual health after a breast cancer diagnosis in young women: clinical implications for patients and providers.

机构信息

University of Colorado Cancer Center, Aurora, CO, USA.

出版信息

Breast Cancer Res Treat. 2020 Dec;184(3):655-663. doi: 10.1007/s10549-020-05880-3. Epub 2020 Sep 23.

Abstract

PURPOSE

Sexual dissatisfaction after breast cancer treatment is a common phenomenon that, unfortunately, places a significant strain on young women and is becoming more common as treatment regimens rely more and more on anti-endocrine therapies.

METHODS

A PubMed review of peer reviewed manuscripts between the years 1998-2020 evaluating sexual health and wellbeing in cancer patients, primarily young women with breast cancer, was conducted.

RESULTS

There are several categories of sexual dissatisfaction women may experience as a result of her breast cancer diagnosis, including menopausal symptoms and dyspareunia, negative body image, reduced sexual desire, strained relationships and partner communication, and anxiety about cancer disclosure in dating relationships. Several methods of addressing each domain have been studied. While hormonal replacement therapy remains controversial, other medication regimens have been shown to be effective in treating menopausal symptoms and dyspareunia. Cognitive behavioral therapy, sex therapy, and couples' therapy are all effective in addressing a variety of symptoms across multiple domains.

CONCLUSIONS

Oncologists are often not prepared to discuss sexual health concerns as frequently as women need. Further work is needed to bring easily digestible and meaningful educational opportunities into clinical practice so young breast cancer survivors can receive comprehensive post-cancer survivorship care.

摘要

目的

乳腺癌治疗后出现性不满是一种常见现象,不幸的是,这给年轻女性带来了巨大的压力,而且随着治疗方案越来越依赖于抗内分泌治疗,这种情况变得越来越普遍。

方法

对 1998 年至 2020 年间评估癌症患者(主要是年轻乳腺癌女性)性健康和幸福感的同行评议文献进行了 PubMed 综述。

结果

女性可能因乳腺癌诊断而经历以下几类性不满,包括更年期症状和性交困难、负面身体形象、性欲降低、紧张的人际关系和伴侣沟通、以及在约会关系中披露癌症的焦虑。已经研究了几种解决每个领域的方法。虽然激素替代疗法仍存在争议,但其他药物治疗方案已被证明可有效治疗更年期症状和性交困难。认知行为疗法、性治疗和夫妻治疗在解决多个领域的多种症状方面都非常有效。

结论

肿瘤学家通常没有准备好像女性需要的那样频繁地讨论性健康问题。需要进一步努力,将易于理解和有意义的教育机会引入临床实践,以便年轻的乳腺癌幸存者能够接受全面的癌症后生存护理。

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