Sexual function, menopausal symptoms, depression and cancer worry in women with BRCA mutations
Menée aux Etats-Unis à partir de données portant sur 244 femmes porteuses d'une mutations BRCA, cette étude analyse l'association, en fonction du statut ménopausique et du recours à une salpingo-ovariectomie prophylactique, entre leur activité sexuelle (fréquence et qualité), des symptômes liés à la ménopause, une dépression et des inquiétudes relatives au cancer
Objectives : Assess sexual function, menopausal symptoms, and depression in women with BRCA mutations associated with oophorectomy and menopause status Methods : Women age 40 and older with BRCA mutations completed a questionnaire with validated measures of sexual activity, menopausal symptoms, depression, and cancer worry. These measures were compared between those with intact ovaries and those who had undergone pre‐ or post‐menopausal risk‐reducing salpingo‐oophorectomy (RRSO). Results :Of the 244 women, 21 women had intact ovaries and 223 women had undergone RRSO. Women with intact ovaries had less menopausal symptoms (Menopausal Symptom Checklist (MSCL) score 14 versus 23, p=0.01) but more cancer worry than women who had undergone RRSO (median Cancer Worry Scale (CWS) score 5 versus 4, p<.0001) with no significant difference in sexual activity or function. Compared to women with postmenopausal RRSO, women with premenopausal RRSO were more likely to be sexually active, (56.3% versus 42.0%, p=0.04), but had similar sexual functioning, including frequency, pleasure and discomfort. Women with premenopausal RRSO were also more likely to report menopausal symptoms (MSCL score 26 versus 19, p=0.04) and depression (PHQ‐8 score 4 versus 2, p<0.001). Factors associated with sexual activity included younger age, lower BMI, living with a partner, and lower depression scores. Higher current depression score was associated with history of depression and more menopausal symptoms. Conclusions : Risk-reducing surgery decreases cancer risk and worry in women with BRCA mutations. Among women undergoing oophorectomy, factors such as age and history of depression were related to reduced sexual activity and increased depression, but menopausal status was not related.