title: 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.
authors.affiliation: Hereditary Cancer Clinic, Prince of Wales Hospital, NSW, Sydney, Australia. b.meiser@unsw.edu.au
authors.forename: B
authors.initials: B
authors.lastname: Meiser
authors.forename: K
authors.initials: K
authors.lastname: Tiller
authors.forename: M A
authors.initials: MA
authors.lastname: Gleeson
authors.forename: L
authors.initials: L
authors.lastname: Andrews
authors.forename: G
authors.initials: G
authors.lastname: Robertson
authors.forename: K M
authors.initials: KM
authors.lastname: Tucker
mesh_terms: D000328:Adult; D000368:Aged; D003657:Decision Making; D005260:Female; D020022:Genetic Predisposition to Disease; D020249:Hormone Replacement Therapy; D006801:Humans; D008593:Menopause; D008603:Mental Health; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control* / Q000601:surgery; D010052:Ovariectomy / Q000523:psychology*; D017060:Patient Satisfaction; D012307:Risk Factors; D019529:Sexuality