Sexual Activity, Psychosexual Distress, and Fear of Progression in Women with Human Papillomavirus-Related Premalignant Genital Lesions
INTRODUCTION:
Genital
human papillomavirus (HPV) infections are very common in women 18 to 30 years
old and substantially affect women's sexual health.
AIM:
To examine
sexual activity, psychosexual distress, and fear of progression in women
diagnosed with HPV-related precancerous genital lesions.
METHODS:
In this
observational study, women diagnosed with premalignant lesions of the cervix,
vagina, or vulva were recruited from a university hospital-based colposcopy
clinic.
MAIN OUTCOME MEASURES:
Quantitative
data from three validated patient-administered questionnaires (Sexual Activity
Questionnaire, German version of the Cervical Dysplasia Distress Questionnaire,
and Fear of Progression Questionnaire) were compared within the study
population, according to the location of the genital lesion, and with relevant
reference populations. Qualitative data from two written open-ended questions
about women's thoughts regarding diagnosis and information were analyzed.
RESULTS:
Two-hundred
nine women completed the questionnaires. Seventy-eight percent of women
(n = 162) were referred for evaluation of suspect lesions of the cervix,
8% (n = 17) of the vagina, and 14% (n = 30) of the vulva. There were
no significant differences in questionnaire results among the three patient
groups, except for sexual consequences (Cervical Dysplasia Distress
Questionnaire) and recent sexual activity (Sexual Activity Questionnaire).
Women with vulvar lesions were most likely to worry about sexual consequences
(ie, being unable to have children, being sexually less attractive, or
infecting a sexual partner; P = .04). The Sexual Activity
Questionnaire subscales sexual pleasure (P = .15) and sexual habits
(P = 1.00) were similar to those in a healthy control population, whereas
sexual discomfort (P = .51) was comparable to that in a reference
population of women who survived cervical cancer. The subscale partner-specific
concerns (Fear of Progression Questionnaire) was similar to that in a reference
population of patients with cancer (P = .28).
CONCLUSION:
HPV-related
precancerous genital lesions, especially of the vulva, are likely to cause
concerns about sexual health. Effective information and communication are
important to lessen negative sexual consequences and anxiety.
- 1Psychology, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria.
- 2Gynecology, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria.
- 3Statistics, Department of Obstetrics and Gynecology, Medical University of Graz, Austria.
- 4Gynecology, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria. Electronic address: gerda.trutnovsky@medunigraz.at.
- J Sex Med. 2016 Jan 9. pii: S1743-6095(15)00028-4. doi: 10.1016/j.jsxm.2015.12.012.
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