BJOG : an international journal of obstetrics and gynaecology · 2026
Sexual Function, Activity and Distress 24 Months After Surgical Menopause: What Happens After Menopause (WHAM)-A Prospective Controlled Study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Hickey Martha, Tejada-Berges Trevor, Domchek Susan M, Krejany Efrosinia O, Brand Alison, Li Peixuan, Braat Sabine, Kingsberg Sheryl
Аннотация
OBJECTIVE: To determine the effect of surgical menopause (risk-reducing salpingo-oophorectomy, RRSO) on sexual function and the modifying effects of HRT.
DESIGN: Prospective observational study of women undergoing RRSO and age-matched comparison group who retained their ovaries.
SETTING: High-risk clinics and general population.
METHODS: Sexual function was measured at baseline, 3, 6, 12 and 24 months.
MAIN OUTCOME MEASURES: Primary outcome was sexual function at 24 months using the Female Sexual Function Index (FSFI). Secondary outcomes included the Fallowfield Sexual Activity Questionnaire (SAQ) and Female Sexual Distress Scale-Revised (FSDS-R).
RESULTS: Baseline sexual function was similar between groups. At 24 months, sexual dysfunction increased from 19% to 42% after RRSO versus 24% to 29% in comparisons (Odds Ratio (OR) 1.9, 95% CI 0.7-5.1; p = 0.21). Compared to comparisons, sexual desire (-0.4, p = 0.02), arousal (-0.7, p < 0.001), lubrication (-0.6, p = 0.01) and satisfaction (-0.6, p < 0.001) were significantly reduced in the RRSO group. Sexual pain (-0.5, p = 0.05) and discomfort (-1.0, p < 0.001) increased after RRSO; sexual habit was unchanged. Sexual distress nearly quadrupled in the RRSO group (OR 3.7, 95% CI 1.6-9.0; p = 0.003). After RRSO, 61% commenced HRT. HRT was not associated with sexual function, activity or distress.
CONCLUSIONS: Sexual dysfunction and distress increased after RRSO. Use of HRT was not associated with better sexual function.
DESIGN: Prospective observational study of women undergoing RRSO and age-matched comparison group who retained their ovaries.
SETTING: High-risk clinics and general population.
METHODS: Sexual function was measured at baseline, 3, 6, 12 and 24 months.
MAIN OUTCOME MEASURES: Primary outcome was sexual function at 24 months using the Female Sexual Function Index (FSFI). Secondary outcomes included the Fallowfield Sexual Activity Questionnaire (SAQ) and Female Sexual Distress Scale-Revised (FSDS-R).
RESULTS: Baseline sexual function was similar between groups. At 24 months, sexual dysfunction increased from 19% to 42% after RRSO versus 24% to 29% in comparisons (Odds Ratio (OR) 1.9, 95% CI 0.7-5.1; p = 0.21). Compared to comparisons, sexual desire (-0.4, p = 0.02), arousal (-0.7, p < 0.001), lubrication (-0.6, p = 0.01) and satisfaction (-0.6, p < 0.001) were significantly reduced in the RRSO group. Sexual pain (-0.5, p = 0.05) and discomfort (-1.0, p < 0.001) increased after RRSO; sexual habit was unchanged. Sexual distress nearly quadrupled in the RRSO group (OR 3.7, 95% CI 1.6-9.0; p = 0.003). After RRSO, 61% commenced HRT. HRT was not associated with sexual function, activity or distress.
CONCLUSIONS: Sexual dysfunction and distress increased after RRSO. Use of HRT was not associated with better sexual function.