title: Addressing sexual dysfunction after risk-reducing salpingo-oophorectomy: effects of a brief, psychosexual intervention.
abstract: BACKGROUND
  Women at high risk for ovarian cancer due to BRCA1 or BRCA2 mutation or family history are recommended to undergo risk-reducing salpingo-oophorectomy (RRSO) after age 35 or completion of childbearing. This potentially life-saving surgery leads to premature menopause, frequently resulting in distressing and unaddressed sexual dysfunction.
  
  
  OBJECTIVE
  To pilot a novel sexual health intervention for women with BRCA1/2 mutations who previously underwent RRSO a using a single-arm trial. Feasibility and primary outcomes including sexual dysfunction and psychological distress were assessed.
  
  
  METHODS
  This single-arm trial included a one-time, half-day educational session comprised of targeted sexual health education, body awareness and relaxation training, and mindfulness-based cognitive therapy strategies, followed by two sessions of tailored telephone counseling. Assessments were completed at baseline and 2 months postintervention.
  
  
  METHODS
  Study end points include feasibility and effectiveness as reported by the participant.
  
  
  RESULTS
  Thirty-seven women completed baseline and postintervention assessments. At baseline, participants had a mean age of 44.4 (standard deviation [SD] = 3.9) years and mean duration of 3.8 (SD = 2.7) years since RRSO. Overall sexual functioning (P = 0.018), as well as desire (P = 0.003), arousal (P = 0.003), satisfaction (P = 0.028), and pain (P = 0.018), improved significantly. There were significant reductions in somatization (P = 0.029) and anxiety scores (P < 0.001), and, overall, for the Global Severity Index (P < 0.001) of the Brief Symptom Inventory. Sexual self-efficacy and sexual knowledge also improved significantly from baseline to postintervention (both P < 0.001). Women were highly satisfied with the intervention content and reported utilizing new skills to manage sexual dysfunction.
  
  
  CONCLUSIONS
  This intervention integrates elements of cognitive behavioral therapy with sexual health education to address a much-neglected problem after RRSO. Results from this promising single-arm study provide preliminary data to move toward conducting a randomized, controlled trial.
authors.affiliation: Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Bober
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Recklitis
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bakan
authors.forename: Judy E
authors.initials: JE
authors.lastname: Garber
authors.forename: Andrea F
authors.initials: AF
authors.lastname: Patenaude
mesh_terms: D000328:Adult; D019313:BRCA1 Protein / Q000235:genetics; D024682:BRCA2 Protein / Q000235:genetics; D015928:Cognitive Behavioral Therapy; D037001:Directive Counseling; D005240:Feasibility Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D009154:Mutation; D010051:Ovarian Neoplasms / Q000517:prevention & control* / Q000523:psychology; D010052:Ovariectomy / Q000379:methods; D010549:Personal Satisfaction; D010865:Pilot Projects; D011788:Quality of Life; D040242:Risk Reduction Behavior; D058994:Salpingectomy; D020377:Self Efficacy; D012725:Sexual Behavior
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human
keywords: Quality of Life and Cancer; Risk-Reducing Salpingo-Oophorectomy and Sexual Dysfunction; Sexual Health and Cancer