The impact of risk-reducing salpingo-oophorectomy
The idea of this thesis was formed on the basis of the expected disruption of quality of life in women choosing risk-reducing salpingo-oophorectomy (RRSO) as prevention strategy. In the search for the consequences of RRSO on menopausal symptoms, sexuality, depression and anxiety, osteoporosis, mental health and cardiovascular health, information was scattered. The lack of overview led to performing a systematic review, chapter 2. In over 3500 patients, described in more than 39 studies, we found that RRSO leads to more severe menopausal complaints and sexual dysfunction than natural menopause. In chapter 3 we specifically looked at the consequences of RRSO on bone health. Therefore we prospectively collected data on bone turnover markers (BTM). We found that the investigated BTMs, P1NP and CTX, increased in premenopausal women following RRSO, suggesting a higher bone turn-over. In postmenopausal women P1NP increased the first six weeks post-RRSO, but this effect was not permanent. Cardiovascular health following RRSO was assessed in chapter 4. In premenopausal women the levels of HDLcholesterol, the cholesterol ratio and HBA1c increased significantly over time, although still staying within reference range. In this group, hot flushes increased over time (p
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