(PA-131) Gender Disparities in Sexual Health Communication Among Patients with Multiple Myeloma: a HealthTree Patient Based Survey Study

Introduction: Sexual health is a critical yet frequently overlooked component of comprehensive care for individuals with multiple myeloma (MM). Only a single study (Henkelman et al, J Psychosoc Oncol Res Pract 2023) has investigated sexual health in a small cohort of 25 women and 40 men with MM; in this survey-based study, patients reported that their symptoms were underaddressed by providers. We sought to examine these findings in a larger cohort with a focus on gender-specific and age-specific differences in sexual health and communication with providers.

Methods: This was a cross-sectional survey of patients with MM using the HealthTree Cure Hub platform. Statistical analyses, including chi-squared tests and regression models, were used to identify trends between groups.

Results: Responses from 345 MM patients (164 women, 181 men) were analyzed. The median age was 66 years, with female respondents younger (62 vs. 68, p< 0.001) and diagnosed at an earlier age (57 vs. 61 years) than male respondents. Survey completion rates were 72% versus 83% for women and men, respectively. Moderate to major impacts on sexual health related to MM or its treatment were reported by 72% of women and 71% of men. Top concerns among women were decreased libido (64%), vaginal dryness (55%), and arousal (46%). For men, top concerns were erectile dysfunction (58%), decreased libido (54%), and arousal (43%). Among women aged < 55, 52% reported a major impact versus 33% aged ≥65 (p = 0.017); among men aged 55–64, 63% reported a major impact versus 37% aged ≥65 (p = 0.014). Among patients aged < 55 at submission, 3% of women and 25% of men reported fertility concerns at diagnosis. Men were more comfortable than women discussing sexual health with their MM care team (75% vs. 45%, p< 0.001) and were more likely to initiate the conversation (36% vs. 24%, p = 0.043). Among symptomatic respondents, only 16% of women received vaginal hormone therapy, whereas 68% of men received treatment for erectile dysfunction.

Conclusions: Sexual health is affected by MM or its treatment in both male and female patients, but the pattern of negative impact is much more prominent in patients aged < 65. We found substantial gender disparities in communication regarding sexual health. Despite similar prevalences of vaginal dryness in women and erectile dysfunction in men, women were much less likely to receive treatment. Despite data that vaginal hormonal therapy does not increase the risk of venous thromboembolism (Svendsen, Basic Clin Pharmacol Toxicol 2021), vaginal hormonal therapy is being utilized in only a minority of female patients despite its potential role in managing sexual health concerns. While limited by survey response bias, our study highlights the need for prospective gender and age-specific guidance around sexual health in MM.