Category: SMSNA Patients
Effects of Risk-Reducing Salpingo-Oophorectomies on the Sexual Function of Breast Cancer Patients
Category: SMSNA Patients
A risk-reducing salpingo-oophorectomy (RRSO) is a surgical procedure intended to reduce the risk of breast and ovarian cancer in people born with the breast cancer (BRCA) 1 or 2 pathogenic variants. Around 46% of BRCA1 carriers and 27% of BRCA2 carriers will have ovarian cancer by the age of 70.
The RRSO removes the ovaries and fallopian tubes, almost completely (90% risk reduction) removing the ability for ovarian cancer to grow. However, ovary removal is guaranteed to result in immediate menopause.
Menopause can have negative effects on sexual and mental health, which may be why around 50% of women with BRCA1 or 2 do not opt for RRSO within the recommended time frame.
Researchers followed 100 women between 34-50 years old with BRCA1 or 2 over a 3–5-year time period to see how sexual function changes for pre-menopausal women following an RRSO.
At the beginning of the study, 58 women had opted not to undergo RRSO, and 41 women agreed to the surgery. Over the course of five years, 30 of the non-RRSO group had decided to undergo the RRSO.
Patients were asked to complete a questionnaire made up of two verified surveys which investigate women’s sexual function and health, menopause symptoms, and quality of life. Changes in responses were recorded periodically over the 5-year study.
Does the RRSO Cause Sexual Dysfunction?
The short answer to this question is that it likely does not cause sexual dysfunction. Researchers concluded that post-RRSO sexual function depended on the patient’s sexual function prior to the surgery. Meaning, if a woman with sexual dysfunction or low sexual function decided to undergo a RRSO, it was likely that her sexual function would not change following the RRSO.
Additionally, both groups experienced a decline in sexual function over time, which is in line with current understandings of age and sexual function. This suggests that it may be unlikely that the RRSO caused the decline.
Because of this the authors suggest that women who agree to a RRSO can be less worried about changes to their quality of life after the fact. Perhaps women who are closer to menopause may be more likely to agree to this type of life-changing surgery. It should be mentioned that in this study, fertility was not a concern in either group of women, which may mean that they were more worried about the menopausal symptoms that would begin earlier than they anticipated.
Key Points
- A risk-reducing salpingo-oophorectomy can reduce the chance of getting ovarian cancer by 90% in women who carry the BRCA1 or 2 variants.
- RRSO comes with the complication of immediate menopause and its symptoms, which may result in a quality-of-life change.
- It appears that the RRSO does not make much of a difference for sexual function – pre-surgery sexual function was similar to post-surgery sexual function.
- Menopause is manageable via hormone replacement therapy. It may be beneficial to speak with your provider about options for symptom management.
Resources:
Rowen, T. S., Boscardin, J., Chen, L.-M., Goldman, M., & Jacoby, V. (2025). Sexual functioning after risk-reducing oophorectomy: A prospective study. The Journal of Sexual Medicine, 22(9), 1606–1611. https://doi.org/10.1093/jsxmed/qdaf183
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