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Sexual Function, Activity and Distress 24 Months After Surgical Menopause: What Happens After Menopause (WHAM)-A
Martha Hickey1, Trevor Tejada-Berges2, Susan M Domchek3
1Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and the Royal Women's Hospital, Melbourne, Victoria, Australia.
BJOG : an International Journal of Obstetrics and Gynaecology
|January 23, 2026
Summary
Risk-reducing salpingo-oophorectomy (RRSO) significantly increases sexual dysfunction and distress in women. Hormone replacement therapy (HRT) did not improve sexual function following RRSO surgery.
Area of Science:
- Gynecology
- Oncology
- Sexual Health
Background:
- Risk-reducing salpingo-oophorectomy (RRSO) is a surgical intervention for women at high risk of ovarian and fallopian tube cancers.
- Surgical menopause induced by RRSO can lead to significant physiological changes, impacting various aspects of women's health.
Purpose of the Study:
- To evaluate the impact of RRSO on female sexual function.
- To investigate the potential modifying effects of hormone replacement therapy (HRT) on sexual function after RRSO.
Main Methods:
- A prospective observational study comparing women undergoing RRSO with an age-matched control group.
- Sexual function was assessed using validated questionnaires including the Female Sexual Function Index (FSFI), Fallowfield Sexual Activity Questionnaire (SAQ), and Female Sexual Distress Scale-Revised (FSDS-R) at multiple time points up to 24 months post-surgery.
Main Results:
- Women undergoing RRSO experienced a significant increase in sexual dysfunction, rising from 19% to 42% at 24 months, compared to a smaller increase in the control group.
- Key aspects of sexual function including desire, arousal, lubrication, and satisfaction were significantly reduced post-RRSO. Sexual pain and discomfort also increased.
- Sexual distress nearly quadrupled in the RRSO group. Hormone replacement therapy (HRT), used by 61% of RRSO patients, showed no association with improved sexual function, activity, or distress.
Conclusions:
- RRSO leads to a significant increase in sexual dysfunction and sexual distress.
- Hormone replacement therapy (HRT) does not appear to mitigate the negative effects of RRSO on sexual function.
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