Perimenopausal androgen decline after oophorectomy does not influence sexuality or psychological well-being

Aziz, Adel; Brännström, Mats; Bergquist, Christer; Silfverstolpe, G.

doi:10.1016/j.fertnstert.2004.12.008

Cited by 85 publications

(57 citation statements)

References 35 publications

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“…Similarly, a study that evaluated hormonal changes after oophorectomy in conjunction with perimenopausal hysterectomy found no significant association with 1 year postoperative sexual or psychological well-being (28). Other prospective studies of oophorectomy are in agreement (29,30).…”

Section: Discussionmentioning

confidence: 88%

Sexual function in young women with spontaneous 46,XX primary ovarian insufficiency

Kalantaridou

Vanderhoof

Calis

et al. 2008

Fertility and Sterility

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Objective-To assess sexual function in women with spontaneous 46,XX primary ovarian insufficiency after at least 3 months of a standardized hormone replacement regimen. Design-Cross-sectional cohort, controlled Setting-National Institutes of Health Clinical Research CenterPatient(s)-Women with primary ovarian insufficiency (N=143) and regularly menstruating controls (N=70).Interventions-Self-administered questionnaires; 100 micrograms/day estradiol patch, oral medroxyprogesterone acetate 10 mg for 12 days each month for patients Main Outcome Measure(s)-Derogatis Interview for Sexual Function Self Report (DISF-SR)Result(s)-Women with primary ovarian insufficiency had significantly lower DISF-SR composite scores as compared to control women. Their serum total testosterone levels were significantly correlated with DISF-SR composite score (r=0.20, P=0.03), although this accounted for only 4% of the variance in this measure. Patients with testosterone levels below normal tended to have lower DISF-SR composite scores. Of patients with primary ovarian insufficiency 9/127 (7%) scored below the 2 nd centile on the composite sexual function score compared to 1/49 (2%) of control women (difference not statistically significant). Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Capsule-Sexual function is in the normal range for most young women with 46,XX spontaneous primary ovarian insufficiency who are receiving physiologic estradiol replacement. Conclusion(s)-As NIH Public Access

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Section: Discussionmentioning

confidence: 88%

Sexual function in young women with spontaneous 46,XX primary ovarian insufficiency

Kalantaridou

Vanderhoof

Calis

et al. 2008

Fertility and Sterility

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“…20 However, a prospective study in a community sample of women undergoing hysterectomy for benign indications with versus without bilateral oophorectomy found no association between decreased androgen levels and sexual or emotional function at 1-year follow-up. 21 In fact, women who had bilateral oophorectomy had no decline in sexual function and improved in overall well-being.…”

Section: Sexual Function Gender and Damage From Cancer Treatmentmentioning

confidence: 99%

Sexuality and Fertility after Cancer

Schover¹

2005

Hematology

164

124

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As more people achieve long-term survival after cancer, sexual dysfunction and infertility have increasingly been recognized as negative consequences that impact quality of life. Sexual dysfunction is a frequent long-term side effect of cancer treatment, but damage to different underlying physiological systems is salient in men versus women. Men frequently have erectile dysfunction (ED) related to damage to the autonomic nervous system and/or reduced circulation of blood to the penis. Hormonal impairment of sexual function is less common. Women, in contrast, are able to overcome damage to autonomic nerves if genital tissues remain structurally intact and estrogenized. Female sexual dysfunction is frequently associated with sudden premature ovarian failure or direct effects of radiation fibrosis or scar tissue causing pain with sexual activity. The lack of validated interventions for sexual rehabilitation after cancer is a major problem, as is finding cost-effective ways of providing services. Concerns about fertility are also a major source of distress to people treated for cancer during childhood or young adulthood, yet many young survivors do not recall any discussion about future childbearing potential with their oncology team. Since fertility preservation is becoming more practical for both men and women, producing patient and professional educational materials and developing professional practice guidelines should be high priorities for oncology societies.As long as cancer treatments cannot be exclusively targeted to tumor cells, damage to the reproductive system will remain an important aspect of cancer morbidity. Problems with sexual function and fertility after cancer are not only ubiquitous, they are less likely to resolve with time than most other treatment side effects. Although not every cancer survivor cares about remaining sexually active, longterm sexual dysfunction has been documented in at least 50% of those treated for breast, prostate, colorectal or gynecological cancer.1 Most available information about sexual dysfunction and fertility is from patients treated for solid tumors. Distress about cancer-related infertility is typically highest among those diagnosed in their reproductive years. Although a much smaller percentage of people treated for cancer are affected by infertility than by sexual dysfunction, 1 in 71 men and 1 in 51 women are diagnosed with a malignancy before age 39.2 Although some cancer treatments can cause both sexual dysfunction and infertility, these two types of morbidity are frequently independent. For example, many young men treated with chemotherapy have poor semen quality, but with all but the highdose regimens, their testosterone levels and sexual function remain normal.3 Therefore, sexual function and fertility will be discussed in separate sections. Sexual Function, Gender, and Damage from Cancer TreatmentThe most common sexual problems after cancer treatment include loss of desire for sex in men or women, erectile dysfunction (ED) in men, and pain with sexual act...

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“…Indeed three recent studies showed that women choosing (as opposed to just consenting to), bilateral oophorectomy with their simple hysterectomy required for benign reasons, do not develop sexual dysfunction over the next 1-3 years. [44][45][46] Despite reduction with age and with menopause, sex hormone production continues, but final hormonal activity may be modulated by various biological factors (Table 3). Before menopause, testosterone is produced by both the ovaries and adrenals: these organs also produce precursor sex hormones, including prasterone (known as dehydroepiandrosterone, DHEA) and androstenedione.…”

Section: Risk Factors For Sexual Dysfunctionmentioning

confidence: 99%

Women's sexual function and dysfunction: current uncertainties, future directions

Basson

2008

Int J Impot Res

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There is increasing evidence that women at the outset of sexual activity do not need to have sexual desire, as in 'drive', and that many do not distinguish desire from arousal. Multiple modes of investigation confirm poor correlation between women's subjective arousal and measured genital congestion. Suggested revisions to the DSM-IV definitions of sexual disorder have been published: there is now need to align interview assessments and screening questionnaires with contemporary understanding of women's sexual response. Whereas the psychological factors associated with women's sexual function and resilience to biological insults and external stressors are well documented, the role of biological factors is less clear. Variations in the rate of decline of adrenal and ovarian pro-hormones, activity of converting enzymes in peripheral cells, sensitivity of androgen and estrogen receptors and cerebral production of sex steroids may all be involved. Thus there is great complexity underlying the question of sex hormone supplementation, and in particular, little clarity as to which women have decreased brain and/or peripheral androgen activity. When psychosexual etiological factors appear to be minimal and investigational testosterone supplementation is considered, it would be appropriate to target women with disordered arousal and desire in keeping with the recently recommended revised definitions.

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Perimenopausal androgen decline after oophorectomy does not influence sexuality or psychological well-being

Cited by 85 publications

References 35 publications

Sexual function in young women with spontaneous 46,XX primary ovarian insufficiency

Sexual function in young women with spontaneous 46,XX primary ovarian insufficiency

Sexuality and Fertility after Cancer

Women's sexual function and dysfunction: current uncertainties, future directions

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