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Women with the BRCA1 or BRCA2 mutations who underwent risk-reducing salpingo oophorectomy and experienced menopause-related sexual dysfunction and associated psychological distress showed improvements after a targeted sexual health education and cognitive-behavioral therapy intervention.
Researchers from the Dana Farber Cancer Institute developed a short-duration, low-intensity intervention to address the physical and psychological effects related to surgically induced menopause.
Participants were recruited through three Boston-area hospitals and an advocacy group’s newsletter based in Boston, Philadelphia and Washington, D.C. Invitations were sent to 259 women; 96 were screened, and 43 women (mean age, 44.4 years) enrolled in the study. Thirty-seven women completed baseline and post-intervention assessments.
Eligibility requirements included women who had undergone risk-reducing salpingo oophorectomy (RRSO) for ovarian cancer risk, acknowledgement of at least one distressing symptom based on the Sexual Function Questionnaire and the ability to speak English. Women with previous history of ovarian cancer, pelvic radiation or chemotherapy within the prior year were excluded, but women with other types of cancers were not excluded if active treatment ended more than 1 year earlier.
The intervention was designed to improve patients’ sexual satisfaction, increase knowledge about sexual function after RRSO, increase the perceived ability to manage their own sexual side effects and to decrease psychological stress.
At baseline, participants completed several questionnaires, including the Female Sexual Function Index, Brief Symptom Inventory-18 and the Sexual Self-Efficacy Scale.
A half-day group session with take-home educational materials, followed by two telephone calls to provide counseling at about 2 and 4 weeks after the session comprised the intervention. Materials consisted of instructions for mindfulness-based body scanning, muscle relaxation exercises, information about vaginal health products and devices, and resources for sexual health information.
After intervention, the questionnaires were re-administered. The greatest magnitude of change was observed in responses about anxiety, sexual self-efficacy and sexual knowledge. Small to moderate increases were shown in responses to the Female Sexual Function Index and its satisfaction, pain and somatization subscales. Small improvements were shown in lubrication and orgasm subscale scores.
“Considering the practical and logistical needs of younger women, most of whom are working, brevity of the intervention was emphasized,” the researchers wrote. “Promising results from this intervention also support the hypothesis that a brief, multimodal educational intervention could provide an acceptable format for sexual rehabilitation for women after RRSO.”
The researchers report no relevant financial disclosures.
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