Efficacy of a couple-based intervention addressing sexual concerns for breast cancer survivors: Results of a randomized controlled trial

BACKGROUND: Sexual concerns are common and problematic for breast cancer survivors. Partner and relationship factors often play a key role in determining survivors' sexual adjustment, making it likely that couple-based interventions that integrate survivors' partners could be especially promising for addressing survivors' sexual concerns. Yet few such interventions have been tested. The objective of this study was to evaluate the efficacy of the Intimacy Enhancement (IE) intervention, a four-session, couple-based intervention addressing breast cancer survivors' sexual concerns by telephone in a randomized controlled trial.

METHODS: Female posttreatment breast cancer survivors reporting sexual concerns and their intimate partners (N = 120 couples; 240 participants) were randomized either to the IE intervention or to Living Healthy Together (LHT), an active control intervention of equivalent length. Outcomes (measured at baseline, postintervention, and at 3 and 6 months postintervention) included breast cancer survivors' sexual function (primary), partners' sexual function (secondary), and survivors' and partners' psychosocial and relationship outcomes (secondary). Mixed linear regression models examined intervention effects on outcomes at all follow-ups.

RESULTS: Model-based estimates of intervention effects showed greater improvements in survivors' overall sexual function, sexual satisfaction, arousal, lubrication, and orgasm at postintervention (p < .05). Effects on survivors' 3-month and 6-month sexual functioning or other secondary outcomes were minimal. Most couples completed all IE sessions (97%) and LHT (92%), and satisfaction ratings were high.

CONCLUSIONS: Compared with an active control intervention, the IE intervention had significant short-term benefits for survivors' sexual function. Efforts may be needed to increase the longevity of the positive effects, such as more frequent or adjunctive treatments.