Symptom: Sexual Dysfunction

Initial Grading Reminder

Note: Erectile dysfunction in men has been reported but generally improves once the deficient hormones are replaced. Therefore, this section focuses on the side effect of decreased sexual drive.

CTCAE grading of decreased sexual drive:

Grade 1: Decrease in sexual interest not adversely affecting relationship
Grade 2: Decrease in sexual interest adversely affecting relationship

Assessment and Grading

Characterize the symptom (onset, pace)

Ask the patient:

Have you had any issues with decreased desire in the past? When did the symptom start? Has it developed gradually or suddenly? Any new medication or medication adjustments recently?

Grade the symptom

Ask the patient:

How would you characterize the change in your sexual drive? Is this affecting your current relationship(s)?

Patient Query Regarding Other Symptoms/Red Flags

Ask the patient:

Do you have other symptoms? Any new or worsening fatigue or depression? Any lumps in your neck? Do you have any severe head pain with vision changes, fever, or nausea and vomiting?

Patient Factors to Consider That Affect the Approach to Intervention

Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?