Management of sexual dysfunction in breast cancer survivors: a systematic review.
Management of sexual dysfunction in breast cancer survivors: a systematic review.
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DOI：
10.1186/s40695-015-0009-4
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发表时间：
2015-01-01
期刊：
影响因子：
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通讯作者：
Su, H Irene
中科院分区：
文献类型：
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作者：
Seav, Susan M;Dominick, Sally A;Su, H Irene
女性性功能障碍经常发生在中年乳腺癌幸存者（BCS）中，包括性欲、兴趣、性唤起、性高潮和生殖盆腔疼痛等问题。尽管性问题很常见，但在BCS中却没有得到充分的诊断和治疗。本综述的目的是评估干预BCS患者性功能障碍的初步研究。2015年2月，系统检索PubMed、SCOPUS、CINAHL、COCHRANE和Web of Science数据库，检索BCS患者阴道（润滑剂、润肤霜、雌激素、脱氢表雄酮[DHEA]、睾酮、振动器、扩张器）、全身（雄激素、抗抑郁药、氟班色林、ospemifene）、物理治疗（体力活动、盆底训练）、咨询和教育干预的随机对照临床试验（RCTs）。由于缺乏随机对照试验，阴道干预的观察性研究也被纳入。检索结果为1414项研究，其中34项符合纳入标准。通过31种不同的性功能量表测量的干预措施和结果都是异质的，因此数据没有汇总。回顾发现，定期和长期使用阴道保湿剂对改善阴道干燥、性交困难和性满意度是有效的。针对性功能障碍的教育和咨询干预在性健康的各个方面显示出持续的改善。体育活动、透皮睾酮或潮热干预均未观察到性健康的持续改善。缺乏bcs关于阴道润滑剂、振动器、扩张器、骨盆底治疗、氟班色林或ospemifene的特定数据。总的来说，这些研究的证据质量是中等到非常低的。由于每种BCS数据干预措施的疗效有限，因此需要临床试验来测试新的干预措施，以提供基于证据的临床建议，并改善BCS患者的性功能。
Female sexual dysfunction occurs frequently in midlife breast cancer survivors (BCS) and encompasses problems with sexual desire, interest, arousal, orgasm and genitopelvic pain. Although common, sexual problems are under-diagnosed and under-treated in BCS. The objective of this review was to assess primary studies that intervene on sexual dysfunction in BCS. In February 2015, PubMed, SCOPUS, CINAHL, COCHRANE and Web of Science databases were systematically searched for randomized controlled clinical trials (RCTs) of vaginal (lubricants, moisturizers, estrogens, dehydroepiandrosterone [DHEA], testosterone, vibrators, dilators), systemic (androgens, anti-depressants, flibanserin, ospemifene), physical therapy (physical activity, pelvic floor training), counseling and educational interventions on sexual function in BCS. Observational studies of vaginal interventions were also included due to the paucity of RCTs. The search yielded 1414 studies, 34 of which met inclusion criteria. Both interventions and outcomes, measured by 31 different sexual function scales, were heterogeneous, and therefore data were not pooled. The review found that regular and prolonged use of vaginal moisturizers was effective in improving vaginal dryness, dyspareunia, and sexual satisfaction. Educational and counseling interventions targeting sexual dysfunction showed consistent improvement in various aspects of sexual health. No consistent improvements in sexual health were observed with physical activity, transdermal testosterone or hot flash interventions. There was a lack of BCS-specific data on vaginal lubricants, vibrators, dilators, pelvic floor therapy, flibanserin or ospemifene. Overall, the quality of evidence for these studies was moderate to very low. Because each of the interventions with BCS data had limited efficacy, clinical trials to test novel interventions are needed to provide evidence-based clinical recommendations and improve sexual function in BCS.