Oophorectomy, the surgical removal of the ovaries, has several known effects on a woman’s physical health as well as, researchers have just discovered, her mind. A new study found that women whose ovaries are removed before menopause face a greater risk of dementia — adding to the mounting evidence that estrogen, a hormone produced by the ovaries, plays a vital role in protecting not only a woman’s body but also her brain functioning well beyond her reproductive years.
At the Mayo Clinic in Rochester, researchers identified a group of 1,489 women who had undergone an oophorectomy within a 38-year period and matched this group with 1,472 women whose ovaries were not removed in that time period. The researchers interviewed either the women or their caregivers (if the women were deceased or unable to report reliably) in both groups and compared prevalence of cognitive impairment, or dementia. Having bilateral (both ovaries) oophorectomy before age 49 was linked with a significant increase in risk of cognitive impairment or dementia. However, women who had both their ovaries removed and were then treated with estrogen until at least age 50 did not have any increased risk.
I spoke with Lynne T. Shuster, MD, women’s health specialist at the Mayo Clinic. She said the increased risk of dementia for women who had both ovaries removed before age 49 was 70% greater… and grew higher the younger the patient was at removal. Meanwhile, the risk of dementia for women who had both ovaries removed and didn’t take estrogen before age 50 was 89% greater than in those whose ovaries were intact.
“This study should give doctors and patients pause to think further about whether or not a woman’s ovaries should be taken out if it’s not absolutely necessary for cancer treatment or prevention in those at high risk,” she said.
“Even after natural menopause, the ovaries have important functions,” noted Dr. Shuster. While they no longer produce estrogen, the ovaries continue to pump out testosterone after menopause, which affects sexual function, bone and muscle strength, mood and energy level. “We advise a woman who has had her ovaries removed at a young age to take estrogen, if possible, at least until the age of natural menopause,” she said. “We also believe there is a critical age window for neuroprotection — meaning estrogen therapy needs to be started soon after ovary removal in order to benefit brain function. If it’s started years later, there may be more risks than benefits.”
If you are under 50 and considering oophorectomy, educate yourself about how the procedure may affect you in the short-term, as well as the long-term. Be sure to discuss with your physician or a menopause specialist whether or not oophorectomy and estrogen replacement is an appropriate and safe option for you.
