The greatest predictor of sexual dissatisfaction after risk-reducing salpingo oophorectomy (RRSO) is sexual dysfunction.1 However, 60% to 80% of patients with BRCA report that they did not receive any information about sexual health preoperatively.2 For women undergoing risk-reducing surgeries for elevated breast or ovarian cancer risk or hereditary predisposition, the impact on sexual health is one of the most influential factors when deciding to undergo these surgeries.3 Among BRCA carriers who have undergone RRSO, impact on sexual health encompasses 2 of the top 3 issues they wish they knew about before surgery. Specifically, hereditary breast or ovarian cancer (HBOC) carriers wish they knew the true impact surgery was going to have on their sexual health, and about the availability of sexual health counseling.2
Preoperative sexual health counseling is paramount for patients to be able to make a fully informed consent regarding surgical options. Comprehensive preoperative counseling has been found to increase surgery preparedness and decrease postsurgical sexual distress.4 However, most healthcare providers do not have the training to provide this counseling. As a result, postoperative symptoms that most often go undiscussed are those that relate to sexual health.2 One does not need to be a sexual health specialist to provide preoperative sexual health counseling. This article provides an outline of the preoperative sexual education essentials for counseling women at high risk for or carriers of HBOC mutations undergoing risk-reducing procedures.
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