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

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. Following RRBSO, non-estrogen 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.