Preventative Ovary Removal In Premenopausal Women Should Be Discontinued, Researchers Warn

Preventative Ovary Removal In Premenopausal Women Should Be Discontinued, Researchers Warn

Ovary removal is commonly used in premenopausal women as a preventive measure against the development of ovarian cancer, but researchers now recommend this practice to be discontinued if women are not at high risk.

The study, “Accelerated Accumulation of Multimorbidity After Bilateral Oophorectomy: A Population-Based Cohort Study,” published in the Mayo Clinic Proceedings, shows that ovary removal in young women is associated with higher incidence of several chronic conditions that markedly affect their health.

Although a number of studies suggests that the long-term risks of ovary removal before menopause are greater than the benefits, some researchers still argue that in the absence of a randomized clinical trial, the evidence against ovary removal is not sufficient to change the practice.

In this study, researchers aimed to address if ovary removal could accelerate the accumulation of multiple chronic diseases, and whether estrogen therapy could modify this accumulation.

Researchers analyzed data from 1,653 premenopausal women included in the Rochester Epidemiology Project records-linkage system. All had undergone removal of both ovaries (or bilateral oophorectomy). Each woman was randomly matched to a woman born in the same year, who had not removed her ovaries.

After a median follow-up of 14 years, removal of both ovaries in women under 46 years old was found to be associated with a significantly increased risk of developing eight out of 18 chronic health conditions investigated, such as depression, hyperlipidemia (excessive levels of fat in the blood), cardiac arrhythmias, coronary artery disease, arthritis, asthma, chronic obstructive pulmonary disease (COPD), and osteoporosis.

Researchers believe that removal of both ovaries triggers an early loss of estrogen, which interferes with several natural aging mechanisms, and leads to the development of diseases that affect multiple systems and organs in the body. Consistently, hormonal therapy with estrogen was found to reduce some of the risk in women who had undergone surgery.

“This study provides new and stronger evidence against the use of bilateral oophorectomy for prevention in young women,” Walter Rocca, MD, and lead author of the study, said in a news release. “Bilateral oophorectomy should not be considered an ethically acceptable option for the prevention of ovarian cancer in the majority of women who do not carry a high-risk genetic variant.”

“The clinical recommendation is simple and clear,” he added. “In the absence of a documented high-risk genetic variant, bilateral oophorectomy before the age of 50 years (or before menopause) is never to be considered and should not be offered as an option to women.”