Climacteric symptoms in women undergoing risk-reducing bilateral salpingo-oophorectomy.
BACKGROUND
The most effective strategy for prevention of ovarian and breast cancer in high-risk women is bilateral salpingo-oophorectomy. The inevitable consequence of the procedure is early menopause with the associated climacteric symptoms. Little is known about the nature of the symptoms in women who undergo risk-reducing bilateral salpingo-oophorectomy.


OBJECTIVE
To compare the nature, frequency, severity, duration, and overall effects of climacteric symptoms in a group of women who underwent preventive bilateral salpingo-oophorectomy as compared to women who experienced natural menopause.


METHODS
Forty-eight women at high risk for ovarian cancer who had risk-reducing bilateral salpingo-oophorectomy were compared to 60 postmenopausal women who had natural menopause. The participants were interviewed about their climacteric complaints, thoughts and feelings regarding the surgical procedure and their general well-being. The climacteric symptoms were evaluated by a modified Greene Climacteric Scale.


RESULTS
Surgical menopause, as compared to natural menopause, was associated with more severe psychological, vasomotor and somatic climacteric symptoms (total score 17.36 vs. 8.65, respectively, p < 0.001) and more significant sexual dysfunction (1.848 vs. 0.900, respectively, p < 0.01). On a 0-10 scale, the satisfaction rate from the surgical procedure was 8.23 +/- 2.21. The surgery did not affect the perceived quality of life (p = 0.347) and decreased the score of anxiety and cancer fear (from 7.75 +/- 3.31 preoperatively to 2.94 +/- 3.08 postoperatively, p < 0.001).


CONCLUSIONS
Risk-reducing bilateral salpingo-oophorectomy as compared to natural menopause is associated with more severe climacteric symptoms. However, the procedure does not interfere with the overall perceived quality of life and improves the perception of cancer risk.
Benshushan
A
A
The Hebrew-University Hadassah Medical School, Department of Obstetrics and Gynecology, Jerusalem, Israel.
Rojansky
N
N
Chaviv
M
M
Arbel-Alon
S
S
Benmeir
A
A
Imbar
T
T
Brzezinski
A
A
D001284:Atrophy; D001526:Behavioral Symptoms / Q000453:epidemiology; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control*; D004644:Emotions; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D019584:Hot Flashes / Q000453:epidemiology; D006801:Humans; D008593:Menopause / Q000502:physiology* / Q000523:psychology; D008594:Menopause, Premature; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control*; D010052:Ovariectomy / Q000009:adverse effects; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology; D013546:Sweating; D013997:Time Factors; D014566:Urogenital System / Q000473:pathology