Menopause International > Volume 14, Number 3 > Pp. 111-116

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Reviews

Prophylactic oophorectomy in premenopausal women and long-term health

Lynne T Shuster ^* , Bobbie S Gostout , Brandon R Grossardt  and Walter A Rocca  ^**

^* Department of Internal Medicine, Women's Health Clinic
Division of Gynecologic Surgery, Department of Obstetrics and Gynecology
Division of Biostatistics, Department of Health Sciences Research
Division of Epidemiology, Department of Health Sciences Research
^** Department of Neurology, Mayo Clinic, Rochester, MN, USA

Correspondence: Lynne T Shuster, MD, FACP, Women's Health Clinic, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Email: lshuster{at}mayo.edu
Objective. To review the data on long-term outcomes in women who underwent prophylactic bilateral oophorectomy, a common surgical procedure that has more than doubled in frequency since the 1960s.

Study design. Literature review of the published data on the consequences of prophylactic bilateral oophorectomy. Special emphasis was given to the Mayo Clinic Cohort Study of Oophorectomy and Aging.

Main outcome measures. Overall mortality, cardiovascular disease, cognitive impairment and dementia, parkinsonism, osteoporosis, psychological wellbeing and sexual function.

Results. There is a growing body of evidence suggesting that the premature loss of ovarian function caused by bilateral oophorectomy performed before natural menopause is associated with several negative outcomes. In particular, studies have revealed an increased risk of premature death, cardiovascular disease, cognitive impairment or dementia, parkinsonism, osteoporosis and bone fractures, decline in psychological wellbeing and decline in sexual function. The effects involve different organs (e.g. heart, bone, or brain), and different functions within organs (e.g. cognitive, motor, or emotional brain functions). Estrogen treatment may prevent some but not all of these negative outcomes.

Conclusion. The potential adverse effects of prophylactic bilateral oophorectomy on heart health, neurological health, bone health and quality of life should be carefully weighed against its potential benefits for cancer risk reduction in women at average risk of ovarian cancer.

Key Words: Prophylactic bilateral oophorectomy • surgical menopause • estrogen deficiency • ageing • mortality • estrogen treatment

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