Body image and sexuality in oophorectomized women

Five groups of women ages 35 to 55 years were studied, including a nonsurgical control group (CTL), a hysterectomy-only (HYS), and three oophorectomy groups: an untreated group (UNT), women on estrogen replacement therapy (EST), and women on androgen-estrogen replacement therapy (COM). The interview/questionnaire session assessed mood, body image, and sexual functioning. In a second session completed by 58 of 129 subjects (45%), a photoplethysmograph measured vaginal blood flow in response to an erotic stimulus while subjects concurrently monitored subjective arousal. Overall, the UNT and EST groups had significantly lower self-reported desire and arousal than the remaining three groups. Body image was significantly poorer in the UNT group. All surgical groups reported more sexual problems than the control group. Furthermore, about a third of the CTL group reported positive changes in body image and sexuality in the previous 5 years. This effect was attenuated in the HYS, COM, and EST groups and almost absent in the UNT group. No significant group differences were obtained, however, on mood or vaginal blood flow and subjective arousal to an erotic stimulus. The role of differential levels of testosterone on sexuality is discussed as well as its clinical implications.