Sexual functioning after risk-reducing oophorectomy: a prospective study

Several studies have suggested a decrease in sexual function after risk-reducing salpingo-oophorectomy (RRSO) that is not mitigated by hormone therapy treatment.

This is a prospective cohort study of women followed from the time of diagnosis, including those who chose whether to proceed with RRSO, and changes in sexual function.

Premenopausal women were recruited from a high-risk cancer genetics clinic at a large academic center and completed detailed demographics and validated measures regarding their physical, mental, and sexual health.

Women were surveyed over the course of 60 months, using the Sexual Health Outcomes in Women Questionnaire (SHOW-Q), and results were analyzed, controlling for known confounders in sexual health, comparing women with and without RRSO.

One hundred women completed the study, 99 of whom completed baseline SHOW-Q surveys. Forty-one women planned RRSO at the beginning of the study, and another 30 underwent an RRSO during the study period. At baseline, women who underwent RRSO had lower sexual functioning scores in terms of sexual satisfaction and pelvic problem interface. Over 60 months, there was no difference in sexual function scores between the RRSO and the no-RRSO group in multivariable models that adjusted for depression, hormone use, menopausal symptoms, or other confounders.

Pre-surgery sexual function predicts post-surgery sexual function, which challenges existing dogma, and women can be reassured that surgery likely won't affect sexual function.

This study's strength was the relatively large sample size and long-term follow-up. Limitations were a relatively homogeneous population that may not reflect the diversity of patient experiences.

These findings can be useful to providers and patients in understanding the effects of surgery and are reassuring that sexual function may, in fact, not be worsened by surgery.