Sexual function following risk-reducing salpingo-oophorectomy: a prospective cohort study

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.