Psychological impact of prophylactic oophorectomy in women at increased risk for ovarian cancer

Abstract

Women with a family history consistent with a hereditary breast/ovarian cancer syndrome are at significantly increased risk for ovarian cancer. Prophylactic oophorectomy is an option for high-risk women. This study explores the psychosexual impact of prophylactic oophorectomy. A qualitative methodology was selected as most appropriate as no previous research has examined this issue. In-depth interviews were conducted with fourteen women, between 4 months and 7 years after prophylactic oophorectomy. Of these, six were pre-and eight were postmenopausal at the time of oophorectomy. Even though individual differences were observed, a majority view was expressed on several issues. All but one participant reported being satisfied with their decision to undergo oophorectomy. Women emphasised that the procedure had decreased their anxiety about developing ovarian cancer. Postmenopausal women reported no negative impact on their libido. Amongst premenopausal women all but one commenced hormone replacement therapy (HRT) following surgery and, in these women, HRT appeared to mitigate the sexual impact of the procedure. Premenopausal women reported unmet information needs both before and after the procedure, including the effects of surgical menopause and the link between HRT and breast cancer. This exploratory study suggests that prophylactic oophorectomy is a psychologically acceptable risk reduction strategy in high-risk women.

A prospective study of quality of life among women undergoing risk-reducing salpingo-oophorectomy versus gynecologic screening for ovarian cancer

“…For older women who may have already been experiencing menopausal symptoms pre-surgery (e.g., vaginal dryness), the post-surgical manifestations of menopause may not be so dramatically different or require as considerable adjustment after surgery. Indeed, this is consistent with a previous study in which postmenopausal women reported no adverse effects of RRSO on their libido [11]. For younger women, however, coping with surgically-induced menopause may require greater adjustment [34, 35], and thus, the physical and psychological consequences of menopause may have a greater negative impact on sexual functioning [36].…”

A prospective study of quality of life among women undergoing risk-reducing salpingo-oophorectomy versus gynecologic screening for ovarian cancer

“…For older women who may have already been experiencing menopausal symptoms pre-surgery (e.g., vaginal dryness), the post-surgical manifestations of menopause may not be so dramatically different or require as considerable adjustment after surgery. Indeed, this is consistent with a previous study in which postmenopausal women reported no adverse effects of RRSO on their libido [11]. For younger women, however, coping with surgically-induced menopause may require greater adjustment [34, 35], and thus, the physical and psychological consequences of menopause may have a greater negative impact on sexual functioning [36].…”

The psychosexual effects of risk-reducing bilateral salpingo-oophorectomy in female BRCA1/2 mutation carriers: A systematic review of qualitative studies

“…Health care professionals should provide information about the real-life changes that the women will experience and the possible impacts it may have on their quality of life. Hormone replacement therapy should always be discussed with women as they often felt that they were not give sufficient information about HRT, how to use it and what it was for (36). Women should be able to make an informed decision about using HRT and if they chose not to, other options should be made available to them.…”

“…In Meiser and colleagues' study (36), all the women reported severe sexual dysfunction, including vaginal dryness and dyspareunia after surgery. This is supported by accounts of the women from another study who reported vaginal dryness prior to HRT (34).…”

Quality-of-Life Effects of Prophylactic Salpingo-Oophorectomy Versus Gynecologic Screening Among Women at Increased Risk of Hereditary Ovarian Cancer

“…18,19,[37][38][39] The vast majority of women in the PBSO group would undergo surgery again, whereas less than two thirds of women undergoing GS would choose screening again. These findings are in line with previous studies.…”

A prospective study of quality of life among women undergoing risk-reducing salpingo-oophorectomy versus gynecologic screening for ovarian cancer

“…For older women who may have already been experiencing menopausal symptoms pre-surgery (e.g., vaginal dryness), the post-surgical manifestations of menopause may not be so dramatically different or require as considerable adjustment after surgery. Indeed, this is consistent with a previous study in which postmenopausal women reported no adverse effects of RRSO on their libido [11]. For younger women, however, coping with surgically-induced menopause may require greater adjustment [34, 35], and thus, the physical and psychological consequences of menopause may have a greater negative impact on sexual functioning [36].…”

The psychosexual effects of risk-reducing bilateral salpingo-oophorectomy in female BRCA1/2 mutation carriers: A systematic review of qualitative studies

“…Health care professionals should provide information about the real-life changes that the women will experience and the possible impacts it may have on their quality of life. Hormone replacement therapy should always be discussed with women as they often felt that they were not give sufficient information about HRT, how to use it and what it was for (36). Women should be able to make an informed decision about using HRT and if they chose not to, other options should be made available to them.…”

“…In Meiser and colleagues' study (36), all the women reported severe sexual dysfunction, including vaginal dryness and dyspareunia after surgery. This is supported by accounts of the women from another study who reported vaginal dryness prior to HRT (34).…”

Quality-of-Life Effects of Prophylactic Salpingo-Oophorectomy Versus Gynecologic Screening Among Women at Increased Risk of Hereditary Ovarian Cancer

“…18,19,[37][38][39] The vast majority of women in the PBSO group would undergo surgery again, whereas less than two thirds of women undergoing GS would choose screening again. These findings are in line with previous studies.…”

A prospective study of quality of life among women undergoing risk-reducing salpingo-oophorectomy versus gynecologic screening for ovarian cancer

“…For older women who may have already been experiencing menopausal symptoms pre-surgery (e.g., vaginal dryness), the post-surgical manifestations of menopause may not be so dramatically different or require as considerable adjustment after surgery. Indeed, this is consistent with a previous study in which postmenopausal women reported no adverse effects of RRSO on their libido [11]. For younger women, however, coping with surgically-induced menopause may require greater adjustment [34, 35], and thus, the physical and psychological consequences of menopause may have a greater negative impact on sexual functioning [36].…”

The psychosexual effects of risk-reducing bilateral salpingo-oophorectomy in female BRCA1/2 mutation carriers: A systematic review of qualitative studies

“…Health care professionals should provide information about the real-life changes that the women will experience and the possible impacts it may have on their quality of life. Hormone replacement therapy should always be discussed with women as they often felt that they were not give sufficient information about HRT, how to use it and what it was for (36). Women should be able to make an informed decision about using HRT and if they chose not to, other options should be made available to them.…”

“…In Meiser and colleagues' study (36), all the women reported severe sexual dysfunction, including vaginal dryness and dyspareunia after surgery. This is supported by accounts of the women from another study who reported vaginal dryness prior to HRT (34).…”

Quality-of-Life Effects of Prophylactic Salpingo-Oophorectomy Versus Gynecologic Screening Among Women at Increased Risk of Hereditary Ovarian Cancer

“…18,19,[37][38][39] The vast majority of women in the PBSO group would undergo surgery again, whereas less than two thirds of women undergoing GS would choose screening again. These findings are in line with previous studies.…”