title: The impact of prophylactic salpingo-oophorectomy on menopausal symptoms and sexual function in women who carry a BRCA mutation.
abstract: OBJECTIVE
  Prophylactic salpingo-oophorectomy is recommended to women who carry a BRCA1 or BRCA2 mutation to reduce the risks of breast, ovarian and fallopian tube cancer. We measured the impact of prophylactic salpingo-oophorectomy on menopausal symptoms and sexual functioning in women with a BRCA mutation.
  
  
  METHODS
  Women who underwent prophylactic salpingo-oophorectomy between October 1, 2002 and June 26, 2008 for a known BRCA1 or BRCA2 mutation were invited to participate. Participants completed questionnaires before prophylactic surgery and again one year after surgery. Measures of sexual functioning and menopausal symptoms before and after surgery were compared. Satisfaction with the decision to undergo prophylactic salpingo-oophorectomy was evaluated.
  
  
  RESULTS
  114 women who underwent prophylactic surgery completed questionnaires before and one year after surgery. Subjects who were premenopausal at the time of surgery (n=75) experienced a significant worsening of vasomotor symptoms (hot flashes, night sweats and sweating) and a decline in sexual functioning (desire, pleasure, discomfort and habit). The increase in vasomotor symptoms and the decline in sexual functioning were mitigated by HRT, but symptoms did not return to pre-surgical levels. HRT decreased vaginal dryness and dyspareunia; however, the decrease in sexual pleasure was not alleviated by HRT. Satisfaction with the decision to undergo prophylactic salpingo-oophorectomy remained high regardless of increased vasomotor symptoms and decreased sexual function.
  
  
  CONCLUSIONS
  Women who undergo prophylactic salpingo-oophorectomy prior to menopause experience an increase in vasomotor symptoms and a decrease in sexual functioning. These symptoms are improved by HRT, but not to pre-surgical levels.
authors.affiliation: Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Finch
authors.forename: K A
authors.initials: KA
authors.lastname: Metcalfe
authors.forename: J K
authors.initials: JK
authors.lastname: Chiang
authors.forename: L
authors.initials: L
authors.lastname: Elit
authors.forename: J
authors.initials: J
authors.lastname: McLaughlin
authors.forename: C
authors.initials: C
authors.lastname: Springate
authors.forename: R
authors.initials: R
authors.lastname: Demsky
authors.forename: J
authors.initials: J
authors.lastname: Murphy
authors.forename: B
authors.initials: B
authors.lastname: Rosen
authors.forename: S A
authors.initials: SA
authors.lastname: Narod
mesh_terms: D000328:Adult; D000368:Aged; D005185:Fallopian Tube Neoplasms / Q000235:genetics / Q000517:prevention & control*; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease; D018095:Germ-Line Mutation; D020249:Hormone Replacement Therapy; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control*; D010052:Ovariectomy; D017060:Patient Satisfaction; D011788:Quality of Life; D012489:Salpingostomy; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D011795:Surveys and Questionnaires