Dr Zachary Nash and his team at the EGA Institute for Women’s Health at University College London (UCL) are running a feasibility study to predict which women will experience persistent menopausal symptoms after having risk-reducing surgery for ovarian cancer (removing fallopian tubes and ovaries).

All women and people with ovaries who have a BRCA 1 or 2 gene alteration are offered surgery to reduce their risk of ovarian cancer, which removes their fallopian tubes and ovaries (a bilateral salpingo-oophorectomy). This surgery is done before the average age of menopause.  

Those who do have the surgery will go into a surgical menopause. This menopause is sudden and often has more severe symptoms than natural menopause. For most women, the symptoms of surgical menopause can be managed with hormone replacement therapy (HRT), but around half will have persistent menopausal symptoms that can have a significant impact on their quality of life, like hot flushes, difficulty sleeping, anxiety, or memory problems (‘brain fog’). The worry about menopausal symptoms can create a barrier to women going for the surgery, leaving them at a higher risk of ovarian cancer.  

To try and address these concerns, the team will recruit up to 30 participants who will be put in a temporary menopause for three months, using medication that is commonly used to treat conditions like endometriosis. The participants will be given HRT and asked to record their symptoms. This first small-scale project will help the team know if this area is worth further research and give them the initial data they need to go for larger pots of funding. 

For those who are likely to have persistent symptoms, two-staged surgery (removal of the fallopian tubes with delayed removal of the ovaries) is a potential future option currently being researched. This research hopes to give women with BRCA 1 and 2 alterations the personalised information they need to inform their options.