Perimenopausal androgen decline after oophorectomy does not influence sexuality or psychological well-being.
OBJECTIVE
To determine whether oophorectomy during the perimenopause, with the associated decline in ovarian androgens, affects sexual function and psychological well-being negatively.


METHODS
Prospective, observational study comparing sexuality and psychological well-being in women after hysterectomy only (HYST) vs. hysterectomy and concomitant oophorectomy (HYST+BSO).


METHODS
University hospital and district general hospital.


METHODS
Three hundred sixty-two perimenopausal women scheduled for elective hysterectomy on benign indication were recruited and 323 (89%) completed the 1-year follow-up (217 in the HYST group and 106 in the HYST+BSO group).


METHODS
The patients were evaluated preoperatively and 1 year after surgery. Postoperatively, estrogen replacement therapy was recommended to all women in the HYST+BSO group and to HYST group subjects with climacteric symptoms.


METHODS
Sex steroids (T, androstenedione, DHEA-S, and E(2)) and sex hormone-binding globulin (SHBG) were measured. Free androgen index and free E(2) index were calculated. Sexuality (McCoy's Female Sex Questionnaire) and psychological well-being (Psychological General Well-Being Index) were evaluated.


RESULTS
Preoperatively, no hormonal differences were found between the two groups. At 1-year follow-up, all sex steroid levels and indices were decreased and SHBG was increased in the HYST+BSO group. Ovarian sex steroids were decreased in the HYST group, whereas DHEA-S and SHBG were unaltered. Sexuality was unaltered in the HYST+BSO group, whereas decreased scores were found in 3 of 14 sexual variables in the HYST group. Psychological well-being was improved in both groups. There were no correlations between the observed changes (data 1 year after surgery, compared with preoperative data) in androgen levels and index and the observed changes in any aspect of sexuality or psychological well-being.


CONCLUSIONS
Hormonal changes after oophorectomy in conjunction with perimenopausal hysterectomy do not significantly change postoperative (1-year) sexual or psychological well-being.
Aziz
Adel
A
Department of Obstetrics and Gynecology, Sahlgrenska Academy at Göteborg University, Borås Hospital, 501 82 Borås, Sweden. adel.aziz@vgregion.se
Brännström
Mats
M
Bergquist
Christer
C
Silfverstolpe
Gunnar
G
D000223:Adaptation, Psychological; D000728:Androgens / Q000097:blood*; D015914:Estrogen Replacement Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D010052:Ovariectomy; D047648:Perimenopause / Q000502:physiology* / Q000523:psychology; D011183:Postoperative Complications / Q000097:blood / Q000188:drug therapy / Q000523:psychology; D019529:Sexuality / Q000502:physiology* / Q000523:psychology; D011795:Surveys and Questionnaires
D000728:Androgens