Care after premenopausal risk‐reducing salpingo‐oophorectomy in high‐risk women: Scoping review and international consensus recommendations

Women at high inherited risk of ovarian cancer are offered risk-reducing salpingo-oophorectomy (RRSO) from age 35 to 45 years. Although potentially life-saving, RRSO may induce symptoms that negatively affect quality of life and impair long-term health. Clinical care following RRSO is often suboptimal. This scoping review describes how RRSO affects short- and long-term health and provides evidence-based international consensus recommendations for care from preoperative counselling to long-term disease prevention. This includes the efficacy and safety of hormonal and non-hormonal treatments for vasomotor symptoms, sleep disturbance and sexual dysfunction and effective approaches to prevent bone and cardiovascular disease.

[1]  R. Lobo.  The 2022 hormone therapy position statement of The North American Menopause Society. , 2022, Menopause.

[2]  W. Chung,et al.  Cancer Risks Associated With BRCA1 and BRCA2 Pathogenic Variants , 2022, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[3]  M. Ceppi,et al.  Safety of systemic hormone replacement therapy in breast cancer survivors: a systematic review and meta-analysis , 2021, Breast Cancer Research and Treatment.

[4]  U. Menon,et al.  Risk-Reducing Salpingo-Oophorectomy and the Use of Hormone Replacement Therapy Below the Age of Natural Menopause , 2021, BJOG : an international journal of obstetrics and gynaecology.

[5]  J. Abbott,et al.  Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Symptom Severity in Women With Postmenopausal Vaginal Symptoms: A Randomized Clinical Trial. , 2021, JAMA.

[6]  T. Snowsill,et al.  Should women with Lynch syndrome be offered gynaecological cancer surveillance? , 2021, BMJ.

[7]  H. V. van Doorn,et al.  Evaluation of a patient decision aid for BRCA1/2 pathogenic variant carriers choosing an ovarian cancer prevention strategy. , 2021, Gynecologic oncology.

[8]  J. Kirk,et al.  What happens after menopause? (WHAM): A prospective controlled study of vasomotor symptoms and menopause-related quality of life 12 months after premenopausal risk-reducing salpingo-oophorectomy. , 2021, Gynecologic oncology.

[9]  N. Phillips,et al.  Management of postmenopausal vulvovaginal atrophy: recommendations of the International Society for the Study of Vulvovaginal Disease , 2021, Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology.

[10]  J. Kirk,et al.  What happens after menopause? (WHAM): A prospective controlled study of sleep quality up to 12 months after premenopausal risk-reducing salpingo-oophorectomy. , 2021, Gynecologic oncology.

[11]  A. Maas,et al.  Association of Salpingectomy With Delayed Oophorectomy Versus Salpingo-oophorectomy With Quality of Life in BRCA1/2 Pathogenic Variant Carriers: A Nonrandomized Controlled Trial. , 2021, JAMA oncology.

[12]  J. Wark,et al.  What Happens After Menopause? (WHAM): A prospective controlled study of cardiovascular and metabolic risk 12 months after premenopausal risk-reducing bilateral salpingo-oophorectomy. , 2021, Gynecologic oncology.

[13]  E. de Azambuja,et al.  Evidence-based approaches for the management of side-effects of adjuvant endocrine therapy in patients with breast cancer. , 2021, The Lancet. Oncology.

[14]  I. Goldstein,et al.  International Society for the Study of Women's Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women. , 2021, The journal of sexual medicine.

[15]  S. Paluch-Shimon,et al.  Breast cancer risk and hormone replacement therapy among BRCA carriers after risk-reducing salpingo-oophorectomy. , 2021, European journal of cancer.

[16]  J. Kirk,et al.  A prospective controlled study of sexual function and sexually related personal distress up to 12 months after premenopausal risk-reducing bilateral salpingo-oophorectomy , 2021, Menopause.

[17]  B. Karlan,et al.  Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. , 2021, Journal of the National Comprehensive Cancer Network : JNCCN.

[18]  Heidi Chang,et al.  Short-term impact of surgically induced menopause on cognitive function and wellbeing in women at high risk for ovarian cancer following risk-reducing bilateral salpingo-oophorectomy. , 2020, Menopause.

[19]  O. Gemer,et al.  Should the risk for uterine cancer influence decision making for prophylactic hysterectomy in BRCA1/2 mutated patients- a systematic review and meta-analysis. , 2020, Gynecologic oncology.

[20]  A. Yasmeen,et al.  Endometrial cancer in germline BRCA mutation carriers: a systematic review and meta-analysis. , 2020, Journal of minimally invasive gynecology.

[21]  Jennifer L Martin,et al.  Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis and GRADE assessment. , 2020, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[22]  J. Wark,et al.  Loss of bone density and bone strength following premenopausal risk–reducing bilateral salpingo-oophorectomy: a prospective controlled study (WHAM Study) , 2020, Osteoporosis International.

[23]  M. Hunter.  Cognitive behavioral therapy for menopausal symptoms , 2020, Climacteric : the journal of the International Menopause Society.

[24]  A. Dobson,et al.  Type of menopause, age of menopause and variations in the risk of incident cardiovascular disease: pooled analysis of individual data from 10 international studies. , 2020, Human reproduction.

[25]  Ying-Yu Chen,et al.  Estrogen for the prevention of recurrent urinary tract infections in postmenopausal women: a meta-analysis of randomized controlled trials , 2020, International Urogynecology Journal.

[26]  N. Watts,et al.  AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY CLINICAL PRACTICE GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS-2020 UPDATE. , 2020, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[27]  C. Crandall,et al.  Safety of vaginal estrogens: a systematic review. , 2020, Menopause.

[28]  J. Simon,et al.  Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder , 2019, Obstetrics and gynecology.

[29]  I. Lambrinoudaki,et al.  Global Consensus Position Statement on the Use of Testosterone Therapy for Women , 2019, The Journal of clinical endocrinology and metabolism.

[30]  B. Rosen,et al.  Changes in Bone Mineral Density After Prophylactic Bilateral Salpingo-Oophorectomy in Carriers of a BRCA Mutation , 2019, JAMA network open.

[31]  E. Petridou,et al.  Surgical menopause in association with cognitive function and risk of dementia: A systematic review and meta-analysis , 2019, Psychoneuroendocrinology.

[32]  Sheryl M. Green,et al.  Cognitive behavior therapy for menopausal symptoms (CBT-Meno): a randomized controlled trial. , 2019, Menopause.

[33]  S. Mirkin,et al.  A systematic review of the efficacy and safety of vaginal estrogen products for the treatment of genitourinary syndrome of menopause , 2019, Menopause.

[34]  Soriul Kim,et al.  Sleep disturbance in women who undergo surgical menopause compared with women who experience natural menopause , 2019, Menopause.

[35]  G. Kenter,et al.  Safety of hormone replacement therapy following risk-reducing salpingo-oophorectomy: systematic review of literature and guidelines , 2019, Climacteric : the journal of the International Menopause Society.

[36]  S. Blair,et al.  Sedentary Behavior, Exercise, and Cardiovascular Health , 2019, Circulation research.

[37]  W. Bobo,et al.  Guidelines for the Evaluation and Treatment of Perimenopausal Depression: Summary and Recommendations. , 2019, Journal of women's health.

[38]  S. Domchek,et al.  Risk factors for sexual dysfunction in BRCA mutation carriers after risk-reducing salpingo-oophorectomy , 2019, Menopause.

[39]  B. Rosen,et al.  Effects of bilateral salpingo-oophorectomy on menopausal symptoms and sexual functioning among women with a BRCA1 or BRCA2 mutation. , 2019, Gynecologic oncology.

[40]  M. Mourits,et al.  Mindfulness‐based stress reduction for menopausal symptoms after risk‐reducing salpingo‐oophorectomy (PURSUE study): a randomised controlled trial , 2018, BJOG : an international journal of obstetrics and gynaecology.

[41]  P. Spritzer,et al.  Risk of venous thromboembolism events in postmenopausal women using oral versus non-oral hormone therapy: A systematic review and meta-analysis. , 2018, Thrombosis research.

[42]  B. Karlan,et al.  Hormone Replacement Therapy After Oophorectomy and Breast Cancer Risk Among BRCA1 Mutation Carriers , 2018, JAMA oncology.

[43]  G. D. de Bock,et al.  Severity and duration of menopausal symptoms after risk-reducing salpingo-oophorectomy. , 2018, Maturitas.

[44]  F. Couch,et al.  Cardiovascular Concerns in BRCA1 and BRCA2 Mutation Carriers , 2018, Current Treatment Options in Cardiovascular Medicine.

[45]  P. Hannaford,et al.  Contemporary Hormonal Contraception and the Risk of Breast Cancer , 2017, The New England journal of medicine.

[46]  M. Hickey,et al.  Non-hormonal treatments for menopausal symptoms , 2017, British Medical Journal.

[47]  N. Aaronson,et al.  Hormone replacement therapy after risk-reducing salpingo-oophorectomy minimises endocrine and sexual problems: A prospective study. , 2017, European journal of cancer.

[48]  J. Manson,et al.  Breast cancer, endometrial cancer, and cardiovascular events in participants who used vaginal estrogen in the Women's Health Initiative Observational Study , 2017, Menopause.

[49]  W. Chung,et al.  Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers , 2017, JAMA.

[50]  S. Xie,et al.  Comparative effectiveness of electro-acupuncture versus gabapentin for sleep disturbances in breast cancer survivors with hot flashes: a randomized trial , 2017, Menopause.

[51]  L. Schover,et al.  A pilot randomized trial to prevent sexual dysfunction in postmenopausal breast cancer survivors starting adjuvant aromatase inhibitor therapy , 2017, Journal of Cancer Survivorship.

[52]  D. Alberts,et al.  Bone loss after oophorectomy among high-risk women: an NRG oncology/gynecologic oncology group study , 2016, Menopause.

[53]  J. Gagne,et al.  Risk of mortality with concomitant use of tamoxifen and selective serotonin reuptake inhibitors: multi-database cohort study , 2016, British Medical Journal.

[54]  M. Murad,et al.  Progesterone vs. synthetic progestins and the risk of breast cancer: a systematic review and meta-analysis , 2016, Systematic Reviews.

[55]  R. Cífková,et al.  ESHRE Guideline: management of women with premature ovarian insufficiency. , 2016, Human reproduction.

[56]  L. Natarajan,et al.  Informing hot flash treatment decisions for breast cancer survivors: a systematic review of randomized trials comparing active interventions , 2016, Breast Cancer Research and Treatment.

[57]  R. Farrell.  Committee Opinion No. 659: The Use of Vaginal Estrogen in Women With a History of Estrogen-Dependent Breast Cancer , 2016, Obstetrics and gynecology.

[58]  Christine Garcia,et al.  Osteoporosis risk and management in BRCA1 and BRCA2 carriers who undergo risk-reducing salpingo-oophorectomy. , 2015, Gynecologic oncology.

[59]  Daniel J Buysse,et al.  The role of sleep hygiene in promoting public health: A review of empirical evidence. , 2015, Sleep medicine reviews.

[60]  A. Caughey,et al.  A Practical Solution for Dyspareunia in Breast Cancer Survivors: A Randomized Controlled Trial. , 2015, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[61]  E. M. Lewiecki,et al.  Clinician’s Guide to Prevention and Treatment of Osteoporosis , 2014, Osteoporosis International.

[62]  J. Schaffer,et al.  Effects of preoperative local estrogen in postmenopausal women with prolapse: a randomized trial. , 2014, The Journal of clinical endocrinology and metabolism.

[63]  M. Sand,et al.  Efficacy and safety of flibanserin in postmenopausal women with hypoactive sexual desire disorder: results of the SNOWDROP trial , 2014, Menopause.

[64]  B. Karlan,et al.  Impact of oophorectomy on cancer incidence and mortality in women with a BRCA1 or BRCA2 mutation. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[65]  A. Giobbie-Hurder,et al.  A randomized, placebo-controlled trial of melatonin on breast cancer survivors: impact on sleep, mood, and hot flashes , 2014, Breast Cancer Research and Treatment.

[66]  J. Manson,et al.  Long-Term Mortality Associated With Oophorectomy Compared With Ovarian Conservation in the Nurses' Health Study , 2013, Obstetrics and gynecology.

[67]  A. LaCroix,et al.  Effect of escitalopram on hot flash interference: a randomized, controlled trial. , 2012, Fertility and sterility.

[68]  J. McAlpine,et al.  Risk-reducing bilateral salpingo-oophorectomy and sexual health: a qualitative study. , 2012, Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC.

[69]  K. Matthews,et al.  Major depression during and after the menopausal transition: Study of Women's Health Across the Nation (SWAN) , 2011, Psychological Medicine.

[70]  Rosalind Eeles,et al.  Association of risk-reducing surgery in BRCA1 or BRCA2 mutation carriers with cancer risk and mortality. , 2010, JAMA.

[71]  A. Giobbie-Hurder,et al.  Augmentation of venlafaxine and selective serotonin reuptake inhibitors with zolpidem improves sleep and quality of life in breast cancer patients with hot flashes: a randomized, double-blind, placebo-controlled trial , 2010, Menopause.

[72]  L. Derogatis,et al.  Validation of the decreased sexual desire screener (DSDS): a brief diagnostic instrument for generalized acquired female hypoactive sexual desire disorder (HSDD). , 2009, The journal of sexual medicine.

[73]  H. Arksey,et al.  Scoping studies: towards a methodological framework , 2005 .

[74]  M. Hickey,et al.  Exploring factors that impact uptake of risk-reducing bilateral salpingo-oophorectomy (RRBSO) in high-risk women. , 2019, Menopause.

[75]  M. Bulsara,et al.  Prevalence of sexual dysfunction after risk-reducing salpingo-oophorectomy. , 2016, Gynecologic oncology.

[76]  A. Patenaude,et al.  Addressing sexual dysfunction after risk-reducing salpingo-oophorectomy: effects of a brief, psychosexual intervention. , 2015, The journal of sexual medicine.