Breaking the silence: Sexual quality of life in Moroccan women after gestational trophoblastic tumors—A cross-sectional study.

Abstract

e24139 Background: Gestational trophoblastic tumors (GTTs) are rare gynecologic malignancies with excellent cure rates. However, survivorship issues, particularly sexual quality of life (SQoL), remain underexplored. Treatment-related toxicity, hormonal disturbances, fatigue, and psychological distress may significantly impair sexual health. In low- and middle-income countries (LMICs) such as Morocco, sociocultural taboos and limited access to sexual health counseling may further exacerbate these challenges. This study aimed to evaluate SQoL and its determinants among Moroccan women treated for GTTs. Methods: We conducted a cross-sectional study in the Medical Oncology Department of CHU Hassan II, Fez, including women who had completed treatment for GTTs. Sexual function and quality of life were assessed using validated instruments, including the Female Sexual Function Index (FSFI) and the EORTC QLQ-C30. Additional items explored sociocultural barriers and partner-related factors. Clinical and demographic data were collected. Statistical analyses were performed to identify factors associated with impaired SQoL. Results: Fifty women aged 23–52 years were included. Based on FSFI scores, 68% presented with sexual dysfunction. After treatment, 10% reported complete cessation of sexual activity. Decreased libido was reported by 74% of participants, vaginal dryness by 58%, and dyspareunia by 52%. Women treated with multi-agent chemotherapy had significantly lower FSFI scores compared with those receiving single-agent regimens (p < 0.05). Qualitative analysis identified lack of partner support, stigma surrounding sexuality, and insufficient medical counseling as major contributors to impaired SQoL. Conclusions: A substantial proportion of Moroccan women treated for GTTs experience persistent sexual dysfunction, driven by both treatment-related and sociocultural factors. These findings highlight the need to integrate sexual health assessment and counseling into routine oncologic follow-up. Addressing sociocultural barriers and improving awareness may enhance survivorship care and quality of life, particularly in LMIC settings.