TY - JOUR
T1 - Hormone replacement therapy after risk-reducing salpingo-oophorectomy minimises endocrine and sexual problems
T2 - A prospective study
AU - Vermeulen, Ravi F.M.
AU - Beurden, Marc van
AU - Kieffer, Jacobien M.
AU - Bleiker, Eveline M.A.
AU - Valdimarsdottir, Heiddis B.
AU - Massuger, Leon F.A.G.
AU - Mourits, Marian J.E.
AU - Gaarenstroom, Katja N.
AU - van Dorst, Eleonora B.L.
AU - van der Putten, Hans W.H.M.
AU - Aaronson, Neil K.
N1 - Funding Information:
This work was supported by a grant from the Dutch Cancer Society (grant number: NKI 2001-2382 ). Appendix A
Publisher Copyright:
© 2017
PY - 2017/10
Y1 - 2017/10
N2 - Background There has been some doubts raised in earlier studies about the efficacy of hormone replacement therapy (HRT) in reducing endocrine and sexual problems in women who have undergone a risk-reducing salpingo-oophorectomy (RRSO). Methods In this prospective, observational study, we recruited 178 premenopausal women with a high risk for ovarian cancer. Fifty-seven women opted for RRSO and 121 for gynaecological screening (GS). Women completed questionnaires before surgery (T1) and 3 (T2) and 9 (T3) months post surgery, or at equivalent time points for the GS-group. Menopausal symptoms were assessed with the Functional Assessment of Cancer Therapy–Endocrine Subscale (FACT-ES) and sexual functioning with the Sexual Activity Questionnaire (SAQ). Groups were compared using repeated measures mixed effect models for continuous variables, and generalised estimating equations for longitudinal ordered categorical data. Results Twenty-seven women who underwent RRSO used HRT after surgery (HRT-users) and 30 did not (HRT-non-users). There were no significant group differences at baseline on the outcome variables. Compared to the HRT-users, the HRT-non-users exhibited a significant increase in overall endocrine symptoms (p = 0.001, effect size (ES) = −0.40 and p < 0.001, ES = −0.59 at T1 and T2, respectively), and in sexual discomfort (p < 0.001, ES = 0.74 and p < 0.001, ES = 1.17). The effect size provides an indication of the magnitude of the observed group differences. An effect size of 0.50 or greater is generally considered to be clinically relevant. No significant differences over time were observed between the HRT-users and the GS-group on any of the outcomes. Conclusion Our results suggest that HRT use in the first year after RRSO has beneficial effects in terms of minimising endocrine symptoms and sexual symptoms in premenopausal women who have undergone RRSO.
AB - Background There has been some doubts raised in earlier studies about the efficacy of hormone replacement therapy (HRT) in reducing endocrine and sexual problems in women who have undergone a risk-reducing salpingo-oophorectomy (RRSO). Methods In this prospective, observational study, we recruited 178 premenopausal women with a high risk for ovarian cancer. Fifty-seven women opted for RRSO and 121 for gynaecological screening (GS). Women completed questionnaires before surgery (T1) and 3 (T2) and 9 (T3) months post surgery, or at equivalent time points for the GS-group. Menopausal symptoms were assessed with the Functional Assessment of Cancer Therapy–Endocrine Subscale (FACT-ES) and sexual functioning with the Sexual Activity Questionnaire (SAQ). Groups were compared using repeated measures mixed effect models for continuous variables, and generalised estimating equations for longitudinal ordered categorical data. Results Twenty-seven women who underwent RRSO used HRT after surgery (HRT-users) and 30 did not (HRT-non-users). There were no significant group differences at baseline on the outcome variables. Compared to the HRT-users, the HRT-non-users exhibited a significant increase in overall endocrine symptoms (p = 0.001, effect size (ES) = −0.40 and p < 0.001, ES = −0.59 at T1 and T2, respectively), and in sexual discomfort (p < 0.001, ES = 0.74 and p < 0.001, ES = 1.17). The effect size provides an indication of the magnitude of the observed group differences. An effect size of 0.50 or greater is generally considered to be clinically relevant. No significant differences over time were observed between the HRT-users and the GS-group on any of the outcomes. Conclusion Our results suggest that HRT use in the first year after RRSO has beneficial effects in terms of minimising endocrine symptoms and sexual symptoms in premenopausal women who have undergone RRSO.
KW - BRCA
KW - Cancer screening
KW - Hormone replacement therapy
KW - Menopause
KW - Ovarian carcinoma
KW - Ovariectomy
KW - Risk-reducing salpingo-oophorectomy
UR - http://www.scopus.com/inward/record.url?scp=85027981581&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2017.07.018
DO - 10.1016/j.ejca.2017.07.018
M3 - Article
C2 - 28818705
AN - SCOPUS:85027981581
SN - 0959-8049
VL - 84
SP - 159
EP - 167
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -