Menopause news

Important consequences of removing ovaries

5 September 2007

Two studies have been reported in the online edition of Neurology, the medical journal of the American Academy of Neurology, published August 29th 2007, which raise concern about the effects of removal of ovaries before the menopause. In one study, 1500 women who had 1 or both ovaries removed for non-cancer related reasons were compared to an equal number of women who still had their ovaries. The women were followed up for 27 years. The women who had 1 or both ovaries removed before menopause, were nearly two times more likely to develop memory problems or dementia than women who did not have surgery and the risk increased with younger age of removal of ovaries. The study also found that the women who had ovaries removed but took estrogen replacement at least up to the age of 50, did not have an increased risk of memory problems.

The second study of 1252 women having 1 ovary removed, 1075 women having both ovaries removed and 2368 women not having surgery, showed that women who had 1 or both ovaries removed before menopause were nearly two times more likely to develop Parkinson's disease and again, the risk increased with younger age of surgery.

Both studies suggest a protective effect of estrogen and that loss of estrogen before the normal age of menopause can have detrimental effects on brain function. Previously the WHI trial showed an increased risk of dementia in women aged >65 who took HRT in the trial so as with the current beliefs around HRT and the heart, it seems that there may be a "Window of opportunity" whereby estrogen in the premenopausal and early postmenopausal years is protective against heart disease, memory problems and dementia but if started too late, can be harmful. Women having an early menopause should be offered estrogen replacement and ideally it should be continued at least until age 50. These recent findings should be considered when balancing risks against benefits of use and duration of HRT.

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