Ravi F M Vermeulen1, Marc van Beurden1, Jacobien M Kieffer2, Eveline M A Bleiker2, Heiddis B Valdimarsdottir3, Leon F A G Massuger4, Marian J E Mourits5, Katja N Gaarenstroom6, Eleonora B L van Dorst7, Hans W H M van der Putten8, Neil K Aaronson9. 1. Department of Gynecology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 2. Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 3. Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA. 4. Department of Gynecology, University Medical Center Nijmegen, Nijmegen, The Netherlands. 5. Department of Gynecology, University Medical Center Groningen, University of Groningen, The Netherlands. 6. Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands. 7. Department of Gynecologic Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. 8. Department of Gynecology, Academic Hospital Maastricht, Maastricht, The Netherlands. 9. Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. Electronic address: n.aaronson@nki.nl.
Abstract
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.
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.
Authors: Lennart J van Winden; Ravi F M Vermeulen; Vincent van den Noort; Katja N Gaarenstroom; Gemma G Kenter; Monique M A Brood-van Zanten; Catharina M Korse; Marc van Beurden; Huub H van Rossum Journal: J Endocr Soc Date: 2022-04-25
Authors: Lara Terra; Maartje J Hooning; Bernadette A M Heemskerk-Gerritsen; Marc van Beurden; Jeanine E Roeters van Lennep; Helena C van Doorn; Joanne A de Hullu; Constantijne Mom; Eleonora B L van Dorst; Marian J E Mourits; Brigitte F M Slangen; Katja N Gaarenstroom; M Carola Zillikens; Tim Leiner; Lizet van der Kolk; Margriet Collee; Marijke Wevers; Margreet G E M Ausems; Klaartje van Engelen; Lieke Pv Berger; Christi J van Asperen; Encarna B Gomez-Garcia; Irma van de Beek; Matti A Rookus; Michael Hauptmann; Eveline M Bleiker; Sanne B Schagen; Neil K Aaronson; Angela H E M Maas; Flora E van Leeuwen Journal: JMIR Res Protoc Date: 2021-01-22
Authors: Lin Zhang; Chenfei Li; Liting Yang; Gabriel Komla Adzika; Jeremiah Ong'achwa Machuki; Mingjin Shi; Qi Sun; Hong Sun Journal: Front Cardiovasc Med Date: 2021-06-16