Exercise for Sexual Health – Making a Difference for Women with Metastatic Breast Cancer

Cancer and Sexuality: A Need That Must Not Be Neglected

A cancer diagnosis and treatment are challenging for patients and their loved ones. Although sexuality may seem to take a back seat during this period, it is a need that substantially affects patients' quality of life. Even in advanced cancers such as metastatic breast cancer, sexual health is highly important for patients' overall well-being and quality of life. Ignoring sexual health problems does not make this need disappear. On the contrary, addressing these problems can improve patients' quality of life and contribute positively to the treatment process. In this context, studies examining the effects of exercise programs on sexual health once again highlight the importance of a holistic approach to cancer treatment.

Exercise Improves Sexual Health in Women with Metastatic Breast Cancer

Women with metastatic breast cancer were studied in a randomized controlled trial whose results have been announced. The trial showed that a structured exercise program improved sexual health problems arising from endocrine treatment, sexual symptoms and complaints, fatigue, and overall quality of life.

A European Union Project

The PREFERABLE-EFFECT study is a project funded under the European Union's Horizon 2020 research and innovation program. The project aims to examine the effects of exercise programs on sexual health, fatigue, and overall quality of life in women with metastatic breast cancer.

Horizon 2020 is a broad funding program run by the European Commission to support scientific research and innovation. During 2014-2020, the program funded research and innovation projects with a budget of 80 billion euros. The main aim of Horizon 2020 is to enhance Europe's global competitiveness and develop its capacity for scientific research and innovation to address societal challenges.

The PREFERABLE-EFFECT project is led by University Medical Center Utrecht in the Netherlands, in collaboration with various research centers in Germany, Poland, Spain, Sweden, the Netherlands, and Australia. The project is a study involving 357 patients with metastatic breast cancer and a 9-month exercise program. Participants took part in supervised aerobic, resistance, and balance exercises and used physical activity trackers throughout the process. The research found that exercise significantly improved patients' quality of life, sexual function, and fatigue levels.

The results of this study were presented at the 2024 European Society for Medical Oncology (ESMO) Breast Cancer Congress and emphasize that physical exercise should be considered an important component of metastatic breast cancer treatment.

Study Details

Patients with metastatic breast cancer frequently experience sexual health problems. Data on the effectiveness of interventions such as exercise are lacking. The PREFERABLE-EFFECT study was conducted in 355 women with metastatic breast cancer (mean age, 55.4 years); 75% of participants were receiving first- or second-line treatment at enrollment, and 68% had bone metastases.

Study participants were randomly assigned to two groups: standard care or a supervised exercise program twice a week for 9 months (aerobic, resistance, and balance exercises). All participants received general exercise advice and an activity tracker. Patients were assessed at baseline and at 3, 6, and 9 months. The effects of the exercise intervention were analyzed using mixed models.

Key Findings

• At baseline, most women showed no interest in sexual activity, and 60% were not sexually active.
• Almost half (46%) of sexually active women reported no or very little sexual pleasure.
• Low sexual function was associated with depression and older age.
• Among patients receiving endocrine (hormone-suppressing) treatment, 27% reported vaginal pain during sexual activity, and 40% reported vaginal dryness.
• The exercise intervention led to significant improvements in sexual function (effect size = 0.28; P = .003) and endocrine sexual symptoms (effect size = 0.25; P = .003) at 6 months, and these effects were maintained at 9 months.
• Sexual pleasure also improved in the exercise group, but this was not statistically significant because of the small sample size.
• Earlier results from the study had shown that the exercise program provided important benefits for fatigue and overall quality of life (the primary outcomes).

Conclusion

Patients with metastatic breast cancer frequently experience sexual health problems, and doctors should address this issue , noted the study presenter, Dr. Martina Schmidt of the German Cancer Research Center. "Physical exercise should be an important component of the prescription we offer our patients," she said.