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Menopause01:28

Menopause

138
Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
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Sexual function following risk-reducing salpingo-oophorectomy: a prospective cohort study.

Åsa Ehlin von Kartaschew1,2, Angelica Lindén Hirschberg2,3, K Gemzell-Danielsson2,3

  • 1LIVIO, 115 42 Stockholm, Sweden.

Sexual Medicine
|November 20, 2024
PubMed
Summary

Risk-reducing salpingo-oophorectomy (RRSO) in BRCA1/2 carriers significantly impairs sexual function compared to controls, independent of testosterone levels. Counseling and support are crucial for managing sexual health post-surgery.

Keywords:
BRCAfemale sexual function indexfree androgen indexmenopausal hormone therapyrisk-reducing salpingo-oophorectomysexual functiontestosterone

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Area of Science:

  • Reproductive Endocrinology
  • Oncology
  • Genetics

Background:

  • Genetic testing for BRCA1/2 pathogenic variants (PV) increases indications for risk-reducing salpingo-oophorectomy (RRSO).
  • RRSO may significantly impact women's sexual function.
  • Understanding these impacts is crucial for patient counseling and care.

Purpose of the Study:

  • To prospectively investigate sexual function in BRCA1/2 PV carriers before and 1 year after RRSO.
  • To compare sexual function in RRSO patients with healthy age-matched controls.
  • To determine if testosterone levels correlate with sexual functioning post-RRSO.

Main Methods:

  • Prospective observational study of 43 BRCA1/2 PV carriers undergoing RRSO and 73 healthy controls.
  • Collected data on medical history, Female Sexual Function Index (FSFI), and serum testosterone/free androgen index (FAI).
  • Assessments were performed pre-RRSO and 1 year post-RRSO, or at baseline for controls.

Main Results:

  • The RRSO group exhibited significantly lower FSFI scores across all domains and a higher prevalence of female sexual dysfunction (FSD) compared to controls at 1 year post-surgery.
  • Menopausal hormone therapy (MHT) use was associated with better sexual function scores in the RRSO group.
  • Lower FAI was observed in the RRSO group at follow-up, but no significant correlation was found between testosterone levels and FSFI scores.

Conclusions:

  • Sexual function significantly deteriorates 1 year after RRSO in BRCA1/2 carriers, irrespective of testosterone levels.
  • The prevalence of impaired sexual function is higher in RRSO patients than in healthy controls.
  • Pre-RRSO counseling and structured follow-up addressing sexual function and MHT are essential.