BJOG · Jan 22, 2026

Sexual Function, Activity and Distress 24 Months After Surgical Menopause: What Happens After Menopause (WHAM)-A Prospective Controlled Study

By Hickey M, Tejada-Berges T, Domchek SM et al.

OBJECTIVE: To determine the effect of surgical menopause (risk-reducing salpingo-oophorectomy, RRSO) on sexual function and the modifying effects of HRT. DESIGN: Prospective observational study of women undergoing RRSO and age-matched comparison group who retained their ovaries. SETTING: High-risk clinics and general population. METHODS: Sexual function was measured at baseline, 3, 6, 12 and 24 months. MAIN OUTCOME MEASURES: Primary outcome was sexual function at 24 months using the Female Sexual Function Index (FSFI). Secondary outcomes included the Fallowfield Sexual Activity Questionnaire (SAQ) and Female Sexual Distress Scale-Revised (FSDS-R). RESULTS: Baseline sexual function was similar between groups. At 24 months, sexual dysfunction increased from 19% to 42% after RRSO versus 24% to 29% in comparisons (Odds Ratio (OR) 1.9, 95% CI 0.7-5.1; p = 0.21). Compared to comparisons, sexual desire (-0.4, p = 0.02), arousal (-0.7, p < 0.001), lubrication (-0.6, p = 0.01) and satisfaction (-0.6, p < 0.001) were significantly reduced in the RRSO group. Sexual pain (-0.5, p = 0.05) and discomfort (-1.0, p < 0.001) increased after RRSO; sexual habit was unchanged. Sexual distress nearly quadrupled in the RRSO group (OR 3.7, 95% CI 1.6-9.0; p = 0.003). After RRSO, 61% commenced HRT. HRT was not associated with sexual function, activity or distress. CONCLUSIONS: Sexual dysfunction and distress increased after RRSO. Use of HRT was not associated with better sexual function.

doi.org/10.1111/1471-0528.70158Open accessPubMed 41572576Populations