Perimenopausal androgen decline after oophorectomy does not influence sexuality or psychological well-being
| Autor: | Adel Aziz, Mats Brännström, G. Silfverstolpe, Christer Bergquist |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Ovariectomy medicine.medical_treatment Hysterectomy Prophylactic Oophorectomy Postoperative Complications Sex hormone-binding globulin Surveys and Questionnaires Adaptation Psychological medicine Humans Gynecology biology Free androgen index business.industry Estrogen Replacement Therapy Obstetrics and Gynecology Oophorectomy Middle Aged Androgen Perimenopause Reproductive Medicine Psychological well-being Androgens biology.protein Female business Sexual function Sexuality Follow-Up Studies |
| Zdroj: | Fertility and Sterility. 83:1021-1028 |
| ISSN: | 0015-0282 |
| DOI: | 10.1016/j.fertnstert.2004.12.008 |
| Popis: | Objective To determine whether oophorectomy during the perimenopause, with the associated decline in ovarian androgens, affects sexual function and psychological well-being negatively. Design Prospective, observational study comparing sexuality and psychological well-being in women after hysterectomy only (HYST) vs. hysterectomy and concomitant oophorectomy (HYST+BSO). Setting University hospital and district general hospital. Patient(s) Three hundred sixty-two perimenopausal women scheduled for elective hysterectomy on benign indication were recruited and 323 (89%) completed the 1-year follow-up (217 in the HYST group and 106 in the HYST+BSO group). Intervention(s) The patients were evaluated preoperatively and 1 year after surgery. Postoperatively, estrogen replacement therapy was recommended to all women in the HYST+BSO group and to HYST group subjects with climacteric symptoms. Main outcome measure(s) Sex steroids (T, androstenedione, DHEA-S, and E 2 ) and sex hormone-binding globulin (SHBG) were measured. Free androgen index and free E 2 index were calculated. Sexuality (McCoy's Female Sex Questionnaire) and psychological well-being (Psychological General Well-Being Index) were evaluated. Results(s) Preoperatively, no hormonal differences were found between the two groups. At 1-year follow-up, all sex steroid levels and indices were decreased and SHBG was increased in the HYST+BSO group. Ovarian sex steroids were decreased in the HYST group, whereas DHEA-S and SHBG were unaltered. Sexuality was unaltered in the HYST+BSO group, whereas decreased scores were found in 3 of 14 sexual variables in the HYST group. Psychological well-being was improved in both groups. There were no correlations between the observed changes (data 1 year after surgery, compared with preoperative data) in androgen levels and index and the observed changes in any aspect of sexuality or psychological well-being. Conclusion(s) Hormonal changes after oophorectomy in conjunction with perimenopausal hysterectomy do not significantly change postoperative (1-year) sexual or psychological well-being. |
| Databáze: | OpenAIRE |
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