Ovary Removal Linked to Early Death

[Angel]

What was once considered a preventive measure is now believed to put young women at risk of an untimely death, according to a new Mayo Clinic study out of Rochester, Minn.

According to the study, there are 1.2 million ovariectomies -- surgical removal of the ovaries also known as oophorectomy -- performed each year in the United States. Of these, an estimated 300,000 are performed to prevent the possibility of future ovarian cancer, a disease the American Cancer Society believes will kill 15,000 women this year alone.

In the study, researchers followed women who underwent an ovariectomy between 1950 and 1987. This included 1,293 women with unilateral ovariectomy, or removal of one ovary, and 1,097 women with bilateral ovariectomy, or removal of both ovaries. All of the women had surgery prior to menopause and for reasons other than cancer. This group was compared to a group of 2,390 women who had not undergone ovariectomy.

Findings from the study reveal death rates rise in women younger than 45 years old who undergo bilateral ovariectomy when they do not receive proper hormone replacement therapy (HRT) afterwards. Mortality from all causes increased nearly two times for women in this age category.

Walter Rocca, M.D., a Mayo Clinic neurologist, epidemiologist, and the study's lead investigator, concludes, "Our results confirm that estrogen is probably protective of the brain and cardiovascular system." He adds, "They also further establish that the effects of estrogen are age-dependent; estrogen may be clearly useful and protective at younger ages, but it may become less important after menopause and then may have no effect or be disadvantageous if given as treatment in later years."

"These findings reopen the debate about preventive removal of ovaries for younger women," reports Bobbie Gostout, M.D., a Mayo Clinic gynecologic surgeon not involved in the study. "Collectively, this information tells us that a procedure that previously looked advantageous in protecting women's health may actually have disadvantages." She adds that, for her, this will change her approach to treating ovarian cancer to include discussions on estrogen replacement therapy backed by findings from the Mayo Clinic study and an emphasis on conservation of the ovaries in women where preventive ovariectomy may have once been considered. She does note, however, that this approach may not be an adequate solution to diminishing risk since compliance with estrogen replacement therapy is generally poor.