A prospective controlled study of sexual function and sexually related personal distress up to 12 months after premenopausal risk-reducing bilateral salpingo-oophorectomy.

Autor: Islam RM; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia., Davis SR; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia., Bell RJ; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia., Tejada-Berges T; Gynaecological Oncology Service, Chris O'Brien Lifehouse, Sydney, Australia., Wrede CD; Department of Obstetrics and Gynaecology, University of Melbourne and The Royal Women's Hospital, Melbourne, Australia.; Gynae-oncology and Dysplasia Unit, The Royal Women's Hospital, Melbourne, Australia., Domchek SM; Basser Center for BRCA, University of Pennsylvania, Philadelphia, PA., Meiser B; Prince of Wales Clinical School, University of New South Wales, Sydney, Australia., Kirk J; Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia., Krejany EO; Gynaecology Research Centre, The Royal Women's Hospital, Melbourne, Australia., Hickey M; Department of Obstetrics and Gynaecology, University of Melbourne and The Royal Women's Hospital, Melbourne, Australia.
Jazyk: angličtina
Zdroj: Menopause (New York, N.Y.) [Menopause] 2021 Mar 15; Vol. 28 (7), pp. 748-755. Date of Electronic Publication: 2021 Mar 15.
DOI: 10.1097/GME.0000000000001766
Abstrakt: Objective: Premenopausal risk-reducing bilateral salpingo-oophorectomy (RRBSO) may impair sexual function, but the nature and degree of impairment and impact of estrogen therapy on sexual function and sexually related personal distress after RRBSO are uncertain.
Methods: Prospective observational study of 73 premenopausal women at elevated risk of ovarian cancer planning RRBSO and 68 premenopausal controls at population risk of ovarian cancer. Participants completed the Female Sexual Function Index and the Female Sexual Distress Scale-Revised. Change from baseline in sexual function following RRBSO was compared with controls at 12 months according to estrogen therapy use.
Results: Baseline sexual function domains did not differ between controls and those who underwent RRBSO and subsequently initiated (56.2%) or did not initiate (43.8%) estrogen therapy. At 12 months, sexual desire and satisfaction were unchanged in the RRBSO group compared with controls. After RRBSO, nonestrogen therapy users demonstrated significant impairment in sexual arousal (β-coefficient (95% confidence interval) -2.53 (-4.86 to -0.19), P < 0.03), lubrication (-3.40 (-5.84 to -0.96), P < 0.006), orgasm (-1.64 (-3.23 to -0.06), P < 0.04), and pain (-2.70 (-4.59 to 0.82), P < 0.005) compared with controls. Although sexually related personal distress may have been more likely after RRBSO, irrespective of estrogen therapy use, there was insufficient data to formally test this effect.
Conclusions: The findings suggest premenopausal RRBSO adversely affects several aspects of sexual function which may be mitigated by the use of estrogen therapy. Further research is needed to understand the effects of RRBSO on sexual function and sexually related personal distress, and the potential for estrogen therapy to mitigate against any adverse effects.
Competing Interests: Financial disclosures/conflicts of interest: M.H. is an editor for the Cochrane Collaboration Group and has received institutional funding for Que Oncology P/L and Madorra P/L research. S.R.D. has been paid for developing and delivering educational presentations for Besins Healthcare, BioFemme and Pfizer Australia, has been on advisory boards for Theramex, Abbott Laboratories, Mayne Pharmaceuticals, and Roche, has been a consultant to Lawley Pharmaceuticals and Que Oncology P/L, and has received institutional funding for Que Oncology P/L research. C.D.W. is an ANZGOG member, has received sponsorship and honoraria from Biogen and Seqirus, is the Deputy Chair (Honorary) of VCS Foundation P/L. S.M.D. is the Executive Director of the Basser Center for BRCA and has received honoraria from AstraZeneca. J.K., R.M.I., R.J.B., T.T-B., B.M., and E.O.K. have no competing interests to declare. The funding organizations have not had any role in the conduct of the research nor the preparation and submission of this article, and there are no other relationships or activities that could appear to have influenced the submitted work.
(Copyright © 2021 by The North American Menopause Society.)
Databáze: MEDLINE