Relationship satisfaction predicts sexual activity following risk-reducing salpingo-oophorectomy

Abstract

Changes in sexual function are a common outcome following risk-reducing salpingo-oophorectomy (RRSO), a prophylactic surgery for women at high risk of ovarian and other gynecologic cancers. Despite the known importance of sexuality in patients' quality of life and satisfaction with surgery, little is known about what predicts sexual activity following RRSO. The present study examined how mental and physical health variables predicted sexual activity before and after RRSO. We conducted a secondary analysis of quality of life measures collected in 85 women at high risk for ovarian cancer. Participants completed validated measures of mental, physical, and relationship health 1–2 weeks before surgery, and 2, 6 and 12 months following surgery. Across analyses, relationship satisfaction emerged as the most significant predictor of change in sexual activity: women with high relationship satisfaction were more likely to continue to have regular sexual activity following RRSO, even in the presence of vaginal menopausal symptoms. The effect of depression, anxiety and overall physical health on sexual activity was non-significant when controlling for relationship satisfaction. When counseling women about RRSO and its impact on sexual activity, clinicians should discuss the effect of the patient's relationship health on this outcome.

• Cancer
• prophylactic oophorectomy
• quality of life
• sexual activity
• sexual function
• women

Current knowledge on this subject

• Sexual problems are commonly reported in women who have undergone prophylactic salpingo oophorectomy, and a strong predictor of dissatisfaction with surgery.

• In naturally menopausal women, relationship satisfaction is a stronger predictor of sexual dysfunction than symptoms related to menopausal transition (e.g. vaginal dryness).

What this study adds

• Prospective measurement of sexual activity, relationship satisfaction, and physical and mental health before and after salpingo oophorectomy.

• Description of predictors of changes in sexual activity following salpingo oophorectomy (although changes are commonly reported, little is known about risk factors or protective factors).

• Confirmation that relationship satisfaction is the strongest predictor of sexual activity following surgical menopause, above and beyond physical symptoms.