Our Summary

This research paper investigates the impact of a certain surgery called risk-reducing bilateral salpingo-oophorectomy (RRBSO) on the sexual function of women who have a high genetic risk of getting ovarian or breast cancer. RRBSO, which involves removing both ovaries and fallopian tubes, is often recommended to these women once they have had all the children they want. While the surgery can greatly reduce the risk of ovarian cancer (by up to 96%), it can also cause side effects like menopausal symptoms and sexual dysfunction.

In the study, the researchers looked at 21 previous studies that included a total of 3201 patients. They found that most of the studies (71%) reported that RRBSO had a negative impact on sexual function. This included less sexual pleasure and more discomfort, although these changes were not significant. However, there was a significant increase in vaginal dryness after the surgery. The frequency of sex did not change much. Whether women were pre-menopausal or post-menopausal at the time of surgery did not make a difference to their sexual function afterwards. Hormone replacement therapy did not remove the negative effects on sexual function.

The researchers concluded that RRBSO does lead to a decline in sexual function, regardless of menopausal status. They suggest that doctors should fully inform patients about the possibility of menopausal symptoms and sexual problems after the surgery, so that they can have realistic expectations and be less distressed after the surgery. They also recommend that all patients should have access to information and support to deal with these side effects.

FAQs

  1. What is a risk-reducing bilateral salpingo-oophorectomy (RRBSO) and who is it recommended for?
  2. What are the potential side effects of RRBSO on sexual function in women?
  3. Do hormone replacement therapies alleviate the negative impacts on sexual function caused by RRBSO?

Doctor’s Tip

One helpful tip a doctor might tell a patient about salpingo-oophorectomy is to be prepared for potential changes in sexual function, including decreased sexual pleasure, discomfort, and an increase in vaginal dryness. It is important to discuss these potential side effects with your healthcare provider and seek support or treatment options if needed.

Suitable For

Patients who are typically recommended salpingo-oophorectomy include women who have a high genetic risk of developing ovarian or breast cancer. This includes women with BRCA1 or BRCA2 gene mutations, as well as those with a strong family history of these cancers. Additionally, women who have completed childbearing and are at high risk for ovarian cancer may also be recommended for this surgery. It is important for these patients to discuss their individual risk factors and treatment options with their healthcare provider to determine if salpingo-oophorectomy is the best course of action for them.

Timeline

Before salpingo-oophorectomy:

  • Patient receives genetic testing and counseling to determine high risk of ovarian or breast cancer
  • Patient decides to undergo risk-reducing bilateral salpingo-oophorectomy (RRBSO) after having all desired children
  • Surgery is scheduled and patient prepares for the procedure
  • Surgery is performed, removing both ovaries and fallopian tubes
  • Recovery period post-surgery

After salpingo-oophorectomy:

  • Patient experiences menopausal symptoms such as hot flashes, night sweats, and mood changes
  • Patient may experience sexual dysfunction, including less sexual pleasure, discomfort, and vaginal dryness
  • Frequency of sex may not change significantly
  • Hormone replacement therapy may not alleviate sexual side effects
  • Patient may receive information and support to cope with menopausal symptoms and sexual problems
  • Patient may need to adjust to changes in sexual function and overall well-being post-surgery

What to Ask Your Doctor

Some questions a patient should ask their doctor about salpingo-oophorectomy include:

  1. What are the potential side effects of the surgery, specifically related to sexual function?
  2. How likely am I to experience menopausal symptoms after the surgery?
  3. Will hormone replacement therapy help with any sexual dysfunction or other side effects?
  4. Are there any alternative treatments or strategies to mitigate the negative impact on sexual function?
  5. How can I access information and support to address any sexual problems that may arise after the surgery?
  6. What is the timeline for recovery and when can I expect to return to normal sexual activity?
  7. How often will I need follow-up appointments to monitor my overall health and well-being post-surgery?

Reference

Authors: Kershaw V, Hickey I, Wyld L, Jha S. Journal: Eur J Obstet Gynecol Reprod Biol. 2021 Oct;265:7-17. doi: 10.1016/j.ejogrb.2021.08.001. Epub 2021 Aug 8. PMID: 34416580