Mayo study: Removing both ovaries in premenopausal women poses more risks than initially thought

ROCHESTER, Minn. – The risks of removing both ovaries for the prevention of cancer are far worse than the benefits when it comes to premenopausal women, according to recent Mayo Clinic research.

Doctors have known the controversial surgery, which is called bilateral oophorectomy, had the potential for negative effects before, but Walter Rocca M.D., a Mayo Clinic Epidemiologist and lead author of the study, says the findings are more dramatic and extensive than they predicted.

The research found that premenopausal women (often younger than age 50) who had their ovaries removed to prevent cancer tended to develop more chronic diseases post-surgery. In fact, all 18 diseases the study specifically looked at increased in the women, with the exception of cancer. Furthermore, the risk of eight of those 18 diseases, including depression, cardiac arrhythmia, arthritis, asthma and osteoporosis, went up significantly. Dr. Rocca explains they found that abrupt loss of estrogen and other hormones causes an acceleration of the aging process.

“I have worked on this question of the consequences of bilateral oophorectomy for about 10 years and I’ve seen a number of negative effects but we have never considered that this would be global, basically all tissues and cells and organs all of the sudden accelerated their decline, it’s as if you were triggering an acceleration of the aging process,” he says.

He hopes the results of this study are the next step in understanding the problem.

“We already had made the statement that it was a risky surgery, but this now makes it a very, very risky surgery.”

Dr. Rocca says only premenopausal women who carry a very high genetic risk, such as the BRCA1 and BRCA2 genetic mutation, should consider the surgery. Even then, he says they should have a very thorough discussion with their doctor about the advantages and disadvantages.

“Also, they need to discuss at what age it would be best to have the surgery and whether they are willing to commit to taking estrogen as a treatment after the surgery,” he adds.

Another alternative, Rocca says, is to develop new ways of diagnosing the cancer early on that would lead to early intervention.

“The problem with ovarian cancer is that it’s a hidden cancer and it does not show any effect until it is too late,” he says. “One of the problems is that we do not have good imaging or biological tests to detect the disease early on like we do for breast cancer and other cancers.”

Something else he points out is that there has been a lot of discussion about removing the fallopian tubes without damaging the ovaries. Some suggest doing so would protect the woman from ovarian cancer because it’s now believed that many ovarian cancers start in the Fallopian tubes.

The bilateral oophorectomy study looked at about 3,000 women and compared a group that had the surgery with a group of women (of the same age) who did not have the surgery. The study sample was made possible by the Rochester Epidemiology Project, which is made up of community members who have agreed to share their medical records for research. For more information on REP, visit the link below:


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