Nearly 23% of women treated for breast cancer reported clinically meaningful sexual distress, defined as emotional responses such as anxiety, frustration or feelings of inadequacy related to sexual difficulties, according to a prospective study recently published in The Journal of Sexual Medicine.
Distress did not significantly change over time and was predicted by higher demoralization.
While overall mean sexual distress levels remained stable across the study period, individual trajectories varied: 52.4% of participants reported improvement, 31.7% reported no change and 15.9% reported worsening symptoms at the six-month follow-up.
Researchers from the University of Haifa conducted the study to examine changes in sexual distress over time and assess the role of specific psychological factors during the posttreatment period.
The research team recruited 190 participants between April and July 2024, with 164 women completing a follow-up assessment six months later, representing a retention rate of 86.3%. Participants were an average of 1.56 years post-diagnosis, with the majority having undergone surgery and systemic therapies.
In longitudinal analyses, higher demoralization predicted higher sexual distress. Demoralization is characterized by feelings of helplessness, hopelessness and loss of meaning and is distinct from clinical depression, as it does not include core features such as loss of interest or pleasure (anhedonia).
Conversely, higher self-compassion was a predictor of lower distress. Self-compassion reflects the ability to respond to personal difficulties with kindness and mindful awareness rather than harsh self-judgment.
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Among clinical variables, estrogen-blocking therapy was associated with higher distress. Age and physical symptom burden, such as vaginal dryness or pain, were not significant predictors after adjustment in multivariate analyses.
According to the researchers, “The findings contribute to growing recognition that sexual distress among breast cancer survivors is shaped by emotional, existential and relational processes — not only physical side effects.”
The authors recommended proactive assessment of sexual concerns in clinical care, including screening for demoralization and low self-compassion to identify individuals who may benefit from early psychosocial interventions to support long-term quality of life.
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