Prevalence of sexual dysfunction after risk-reducing salpingo-oophorectomy Paige E. Tucker a,b, ⁎, Max K. Bulsara c , Stuart G. Salfinger a , Jason Jit-Sun Tan a , Helena Green d , Paul A. Cohen a a St John of God Subiaco Hospital, 12 Salvado Rd, Subiaco, WA 6008, Australia b School of Medicine, University of Notre Dame, 19 Mouat St, Fremantle, WA 6160, Australia c Institute for Health Research, University of Notre Dame, 19 Mouat St, Fremantle, WA 6160, Australia d Women Centre, 2 McCourt St, West Leederville, WA 6007, Australia HIGHLIGHTS • Study of 119 women who have undergone risk-reducing salpingo-oophorectomy (RRSO) • The prevalence of female sexual dysfunction (FSD) after RRSO was 74%. • The prevalence of hypoactive sexual desire disorder (HSDD) after RRSO was 73%. • Significant factors were relationship satisfaction, bodily pain, and vaginal estrogen. • Serum testosterone and free androgen index are not associated with sexual function. abstract article info Article history: Received 3 October 2015 Received in revised form 27 October 2015 Accepted 2 November 2015 Available online 3 November 2015 Keywords: Risk-reducing salpingo-oophorectomy Prophylactic oophorectomy Female sexual function Androgen levels BRCA1 BRCA2 Lynch syndrome Ovarian cancer Female sexual dysfunction Hypoactive sexual desire disorder Breast cancer Objectives. To determine the prevalence of sexual dysfunction in women after risk-reducing salpingo- oophorectomy (RRSO) and to assess factors which may influence sexual wellbeing following this procedure. Methods. This work is a cross-sectional study of women who underwent RRSO at a tertiary gynecologic oncol- ogy unit between January 2009 and October 2014. Data collection involved a comprehensive questionnaire in- cluding validated measures of sexual function, sexual distress, relationship satisfaction, body image, impact of event, menopause specific quality of life, and general quality of life. Participants were invited to undergo blood testing for serum testosterone and free androgen index (FAI). Results. 119 of the 206 eligible women participated (58%), with a mean age of 52 years. The prevalence of fe- male sexual dysfunction (FSD) was 74% and the prevalence of hypoactive sexual desire disorder (HSDD) was 73%. Common sexual issues experienced included; lubrication difficulty (44%), reduced sexual satisfaction (41%), dyspareunia (28%) and orgasm difficulty (25%). Relationship satisfaction, the use of topical vaginal estrogen and lower generalized body pain were significantly associated with a decreased likelihood of sexual dysfunction. Serum testosterone, FAI, the use of systemic hormone replacement therapy (HRT), prior history of breast cancer, menopausal status at the time of surgery and hysterectomy did not correlate with sexual dysfunction. Conclusion. The prevalence of FSD and HSDD after RRSO was 74% and 73% respectively. Relationship satisfac- tion, low bodily pain and use of topical vaginal estrogen were associated with a lower likelihood of sexual dys- function. There was no correlation between serum testosterone or FAI, and sexual dysfunction. © 2015 Elsevier Inc. All rights reserved. 1. Introduction 1.1. Background and rationale The current recommendation for women at high risk of ovarian can- cer is to undergo risk-reducing salpingo-oophorectomy (RRSO) at 35– 40 years of age, and upon completion of child bearing [1]. RRSO has re- cently received significant publicity, and with improved access to genet- ic testing; the number of women electing to undergo this surgery is likely to increase, despite emerging interest in bilateral salpingectomy Gynecologic Oncology 140 (2016) 95–100 ⁎ Corresponding author. E-mail addresses: Paige.Tucker@sjog.org.au (P.E. Tucker), Max.Bulsara@nd.edu.au (M.K. Bulsara), Stuart.Salfinger@health.wa.gov.au (S.G. Salfinger), Jason@womencentre.com.au (J.J.-S. Tan), Helena@relate-sexology.com.au (H. Green), Paul.Cohen@sjog.org.au (P.A. Cohen). http://dx.doi.org/10.1016/j.ygyno.2015.11.002 0090-8258/© 2015 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Gynecologic Oncology journal homepage: www.elsevier.com/locate/ygyno