Mortality from all causes increased 1.7 times for women in this age category, and was particularly increased for estrogen-related cancers and diseases of the brain and cardiovascular system. The increased risk was mainly restricted to those women who were not given estrogen after the surgery until at least age 45 (within five years of the approximate age of normal menopause). Also, the increased risk became evident only 10 or more years after the ovariectomy.
“These findings reopen the debate about preventive removal of the ovaries for younger women,” says Bobbie Gostout, M.D., Mayo Clinic gynaecologic surgeon who is not a study author but consulted with Dr. Rocca. “We don’t see a dramatic increase in risk for early death from any one condition, but Dr. Rocca’s study did show some increase in risk of death from breast and uterine cancers, and neurologic and vascular conditions. Collectively, this information tells us that a procedure that previously looked advantageous in protecting women’s health may actually have disadvantages. We need to be very thoughtful about ovariectomy, as it may put younger women at risk for an earlier death.”
Dr. Rocca M.D., Mayo Clinic neurologist, epidemiologist and lead study investigator says that if a woman under 45 has ovarian cancer or a benign disease in the ovaries that requires removal, however, compelling reason remains to remove the ovaries. Removal may also be considered in older women and in women with a very high risk of ovarian cancer, he says.
Continuing preventive ovariectomies in average-risk younger women and emphasizing estrogen replacement therapy thereafter may not be an adequate solution to diminish the risk, however, as compliance is poor for taking estrogen replacement therapy, says Dr. Gostout. Dr. Rocca adds that the protective effect from endogenous estrogen -- estrogen coming naturally from one’s own ovaries with daily and monthly cyclic variations -- may not be the same as the effect of estrogen replacement therapy.
MEDICA.de; Source: Mayo Clinic