title: Sexual activity and functioning after risk-reducing salpingo-oophorectomy: Impact of hormone replacement therapy.
abstract: OBJECTIVE
  To examine sexual activity and functioning in women after risk-reducing salpingo-oophorectomy (RRSO) compared with the general population (NORM).
  
  
  METHODS
  Retrospective cohort study. 294 women who underwent RRSO and 1228 women from the NORM group provided written information based on mailed questionnaires. Sexual pleasure and discomfort scores and frequency of sexual activity were evaluated using the Sexual Activity Questionnaire.
  
  
  RESULTS
  The RRSO group reported less sexual pleasure (10.5 vs. 11.9, P=0.009), more discomfort (1.9 vs. 0.83, P<0.001), and less frequent sex than did the controls. Significant associations were observed between a lower pleasure score and being in the RRSO group, older age, history of cancer, low body image, high level of role functioning, and low level of global quality of life (QoL). Further, significant associations were detected between more discomfort and being in the RRSO group, older age, history of cancer, poor body image, and low level of global QoL. Hormone replacement therapy (HRT) use had no impact on pleasure or discomfort score in regression analyses among all the sexually active women. However, in subanalyses of the RRSO group, users of systemic HRT reported less discomfort (1.2 vs. 2.4, P=0.001) than did the nonusers.
  
  
  CONCLUSIONS
  After RRSO, women reported significantly less sexual pleasure, more discomfort, and less frequent sex compared with the controls. In the RRSO group, systemic HRT users reported less discomfort than did the nonusers. Health care providers should be attentive to these issues when counseling before and after prophylactic surgery.
authors.affiliation: Department of Gynecology, Sørlandet Hospital Arendal, P.O. Box 783, 4809 Arendal, Norway; Research Unit, Sørlandet Hospital, P.O. Box 416, 4604 Kristiansand, Norway. Electronic address: nora.johansen@sshf.no.
authors.forename: Nora
authors.initials: N
authors.lastname: Johansen
authors.affiliation: Department of Gynecology, Sørlandet Hospital Arendal, P.O. Box 783, 4809 Arendal, Norway; Research Unit, Sørlandet Hospital, P.O. Box 416, 4604 Kristiansand, Norway.
authors.forename: Astrid H
authors.initials: AH
authors.lastname: Liavaag
authors.affiliation: Institute of Clinical Medicine, University of Oslo, P.O. Box 1072 Blindern, 0316 Oslo, Norway; Department of Gynecology, Oslo University Hospital Rikshospitalet, P.O. Box 4950 Nydalen, 0424 Oslo, Norway.
authors.forename: Tom G
authors.initials: TG
authors.lastname: Tanbo
authors.affiliation: National Resource Center for Late Effects after Cancer Treatment, Oslo University Hospital, Norwegian Radium Hospital, P.O. Box 4953 Nydalen, 0424 Oslo, Norway.
authors.forename: Alv A
authors.initials: AA
authors.lastname: Dahl
authors.affiliation: Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway.
authors.forename: Are H
authors.initials: AH
authors.lastname: Pripp
authors.affiliation: Research Unit, Sørlandet Hospital, P.O. Box 416, 4604 Kristiansand, Norway; Department of Obstetrics Rikshospitalet, Women and Children's Division, Oslo University Hospital, P.O. Box 4950, 0424 Oslo, Norway; Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, P.O. Box 4950 Nydalen, 0424 Oslo, Norway.
authors.forename: Trond M
authors.initials: TM
authors.lastname: Michelsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001828:Body Image; D001943:Breast Neoplasms / Q000517:prevention & control; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000517:prevention & control; D010052:Ovariectomy / Q000009:adverse effects / Q000379:methods*; D057181:Pleasure; D012189:Retrospective Studies; D058994:Salpingectomy / Q000009:adverse effects / Q000379:methods*; D012725:Sexual Behavior / Q000187:drug effects / Q000502:physiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: BRCA mutation; Controls; Hormone replacement therapy; Risk-reducing salpingo-oophorectomy; Sexual activity and functioning