Our Summary

This research paper explores why women with BRCA1/2 genetic mutations, who have had their ovaries and fallopian tubes removed as a preventative measure against cancer, do not use hormone therapy (HT). The study surveyed 60 women who had undergone this procedure and found that just 40% had ever used HT. The use of HT was higher in women who had the procedure at a younger age (under 45). Most women reported that their doctor had discussed HT with them, but many had also seen conflicting information in the media about the long-term effects of HT. The main reasons women did not start HT were that their doctor did not recommend it or they believed it was not necessary. The study suggests that there are barriers to HT use, including patient worries and doctors not recommending it, and that there is room for better education in this area.

FAQs

  1. Why do women with BRCA1/2 genetic mutations have their ovaries and fallopian tubes removed?
  2. What are the main reasons why women who have undergone salpingo-oophorectomy do not use hormone therapy?
  3. What barriers to hormone therapy use were identified in the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about salpingo-oophorectomy is to discuss the potential benefits of hormone therapy (HT) after the procedure. HT can help manage menopausal symptoms and reduce the risk of developing osteoporosis and heart disease. It’s important for patients to have an open and honest conversation with their healthcare provider about the pros and cons of HT to make an informed decision that is best for their overall health and well-being.

Suitable For

Salpingo-oophorectomy is typically recommended for women who are at high risk of developing ovarian or fallopian tube cancer. This includes women with BRCA1/2 genetic mutations, as these mutations significantly increase the risk of developing these types of cancer. Additionally, salpingo-oophorectomy may be recommended for women with a strong family history of ovarian or fallopian tube cancer, or for women with certain conditions such as endometriosis or pelvic inflammatory disease.

Other types of patients who may be recommended salpingo-oophorectomy include women with a history of breast cancer who are at increased risk of developing ovarian cancer, women with a history of hormone-receptor positive breast cancer who are at increased risk of developing a new breast cancer, and women with certain genetic syndromes such as Lynch syndrome or Peutz-Jeghers syndrome.

Overall, salpingo-oophorectomy is typically recommended for women who are at high risk of developing ovarian or fallopian tube cancer, or who have other conditions that may warrant the removal of their ovaries and fallopian tubes.

Timeline

Before salpingo-oophorectomy:

  • Patient may undergo genetic testing to determine if they have BRCA1/2 mutations
  • Patient may receive counseling about their risk of developing cancer and the option of preventative surgery
  • Patient may decide to undergo salpingo-oophorectomy to reduce their risk of ovarian and fallopian tube cancer
  • Patient may discuss the possibility of hormone therapy with their doctor before the surgery

After salpingo-oophorectomy:

  • Patient undergoes the surgical removal of their ovaries and fallopian tubes
  • Patient may experience menopausal symptoms such as hot flashes, night sweats, and vaginal dryness due to the sudden loss of estrogen
  • Patient may discuss hormone therapy with their doctor as a way to manage menopausal symptoms and potentially reduce the risk of other health issues associated with early menopause
  • Patient may decide to start or not start hormone therapy based on their doctor’s recommendation, personal beliefs, and concerns about the long-term effects of hormone therapy
  • Patient may experience challenges in accessing accurate information about hormone therapy and may face barriers to starting hormone therapy, such as conflicting information in the media or lack of recommendation from their doctor.

What to Ask Your Doctor

  1. What are the potential risks and benefits of hormone therapy after undergoing a salpingo-oophorectomy?
  2. How soon after the surgery can hormone therapy be started?
  3. What are the different types of hormone therapy available and which would be most suitable for me?
  4. How long should I be on hormone therapy after the surgery?
  5. Are there any alternatives to hormone therapy that I should consider?
  6. Are there any specific factors in my medical history or family history that would affect my decision to use hormone therapy?
  7. How often should I have follow-up appointments to monitor the effects of hormone therapy?
  8. Are there any lifestyle changes or additional preventive measures I should take after the surgery in addition to hormone therapy?
  9. What are the long-term effects of not using hormone therapy after a salpingo-oophorectomy?
  10. Can you provide me with resources or additional information about hormone therapy and its benefits for women who have undergone this procedure?

Reference

Authors: DiSilvestro JB, Haddad J, Robison K, Beffa L, Laprise J, Scalia-Wilbur J, Raker C, Clark M, Lokich E, Hofstatter E, Dalela D, Brown A, Bradford L, Toland M, Stuckey A. Journal: Menopause. 2023 Jul 1;30(7):732-737. doi: 10.1097/GME.0000000000002201. Epub 2023 May 16. PMID: 37192837