Sexual Functioning in Long-Term Survivors of Hematopoietic Cell Transplantation

•Thirty-nine percent of women and 27% of men reported no sexual activity in the first year after undergoing hematopoietic stem cell transplantation (HCT).•Of sexually active individuals, 64% of women and 32% of men reported low sexual function.•Rates of sexual dysfunction did not differ across the years after HCT.•Function declines with aging, low performance status, and lack of a stable relationship.•Vaginal dryness (63%), erectile dysfunction (38%), and low libido were the most prevalent complaints. This investigation characterized sexual activity and sexual function in hematopoietic cell transplantation (HCT) survivors, compared them with norms, and examined factors associated with sexual dysfunction, with the goal of identifying targets for intervention to improve sexual health. Surviving adults from a large transplantation center were asked to complete an annual survey with a core of health questions and a module on sexual activity and function. Participants completed the Sexual Function Questionnaire, Cancer and Treatment Distress form, and Revised Dyadic Adjustment Scale. Clinical data were collected from the transplantation medical database. Multivariate logistic regressions identified factors associated with sexual activity and function. Participating survivors (n = 1742) were a mean of 11.9 years (range, .4 to 43.1 years) after HCT, mean age 57.6 years, and 53% male. Women were more likely than men to report being sexually inactive in the past year (39% versus 27%) and, among those sexually active, to report low sexual function (64% versus 32%). Male and female survivors reported lower rates of sexual activity and function than comparison norms (all P < .01). In regressions, factors associated with being sexually inactive included older age, having