DISCUSSION
dyspareunia
DYSPAREUNIA, SECONDARY, SURGICAL MENOPAUSE
For women with a Pre‐menopausal removal of the ovaries results in abrupt surgical menopause and menopausal symptoms, including more vaginal dryness and dyspareunia and less pleasure and satisfaction during sexual activity.In the current study, women had elevated levels of decisional conflict related to RRSO at baseline. These elevated levels of decisional conflict were observed again at 1 year for women randomized to usual care. However, for women who received the intervention, decisional conflict was significantly lower at 1 year. Women in the intervention arm went from scores that suggested that a decision about RRSO would not be made, to a mean score suggesting that a decision would be made. This suggests that the behavioral intervention may have targeted domains specific to decisional conflict, including knowledge, harms and benefits of options, and support.Knowledge is a modifiable decisional need that contributes to decisional conflict.At one‐year post‐randomization, there were no differences in RRSO uptake between the intervention and usual care groups (28.6% vs. 22.9%; Most women who learn that they have a There are several strengths to this study including the rigorous methodology employed in the randomized controlled trial, including stratification by site of referral. We recruited women from throughout North America using a variety of sources, including self‐referral which contributed to the generalizability of our findings. We used a theoretically‐derived intervention with relatively rigorous supervision and quality control.There are limitations to this study, including the small sample size that did not meet the planned sample size requirements (not powered for primary outcome). We still observed significant differences between groups in secondary outcomes, including decisional conflict and knowledge. In addition, we did observe significant differences in RRSO uptake after 2 years between those who received the intervention compared to those who received usual care, which could have been due to wait times for consulations and surgery. In addition, the women included in this study self‐selected to be involved in a research study and may not be representative of the population of women with a Overall, this study provides evidence that a theory‐based behavioral intervention delivered by genetic counselors to women with a 