Risk factors for sexual dysfunction in BRCA mutation carriers after risk-reducing salpingo-oophorectomy

Area of Science:

• Oncology
• Gynecology
• Sexual Medicine

Background:

• BRCA mutations increase cancer risk, often leading to risk-reducing salpingo-oophorectomy (RRSO).
• Sexual dysfunction is a significant concern for women undergoing RRSO, impacting quality of life.

Purpose of the Study:

• To identify risk factors for sexual dysfunction in BRCA mutation carriers after RRSO.
• To analyze factors associated with the most severe sexual dysfunction phenotypes.

Main Methods:

• Cross-sectional study surveying BRCA1/2 mutation carriers with and without RRSO.
• Assessment of sexual function using the Female Sex Function Index (FSFI), alongside demographic, medical, sleep, depression, and anxiety data.
• Analysis of risk factors for the lowest quartile of FSFI scores.

Main Results:

• Sexual dysfunction reported in 77.3% of 529 BRCA carriers who underwent RRSO.
• Significant associations found between sexual dysfunction and poor sleep, hot flashes, lack of hormone therapy (HT), depression, and anxiety.
• Depression (aOR 2.4) and hot flashes (aOR 1.9) remained significant risk factors in adjusted analyses. HT use was associated with decreased risk (aOR 0.6).

Conclusions:

• Sexual dysfunction is highly prevalent in BRCA carriers post-RRSO.
• Depression is a significant, potentially under-recognized risk factor for sexual dysfunction.
• Education on sexual side effects and risk factors is crucial; HT may improve sexual function.