A Mayo Clinic study has strongly recommended against the practice of removing both ovaries in premenopausal women as a way to prevent ovarian cancer.
The reason for this urging is that the researchers found a significant increased rate of aging, as determined by a measure of chronic health problems. Specifically, the lead author said that removing both ovaries should not be seen as “an ethically acceptable option” for women who do not have a high risk of cancer.
In Brief: Ovarian Removal
The formal term for removing both ovaries is “bilateral oophorectomy”. The procedure is often done as a preventative measure against ovarian cancer, which is tricky to both detect and cure. In 2013, there were 21,000 cases and 14,276 deaths from the disease. Although the American College of Obstetricians and Gynecologists says strong consideration should be given to retaining the ovaries of premenopausal women of average risk, this is not always what happens in clinical settings.
The Mayo Clinic Study
The researchers followed 1,653 women who underwent a bilateral oophorectomy and an equal number of women the same age who did not. They were tracked for an average period of 14 years and were monitored for how fast they aged.
There is no universally accepted measurement for aging, and different aging studies regularly use varying markers. In this case, the Mayo researchers looked at the development of 18 chronic health conditions. These conditions included depression, hyperlipidemia, cardiac arrhythmias, coronary artery disease, arthritis, asthma, chronic obstructive pulmonary disease, and osteoporosis. These conditions not only crop up more as people get older, they are also more likely to be multiple diagnoses of these conditions in the same person. This was used as the aging measure.
The results showed that women under age 46 who underwent bilateral oophorectomy had a higher incidence of all 18 conditions (except cancer) when examined one at a time. There was a higher, marked increase in the rate of the eight conditions listed above. The women also had a faster accumulation of diagnoses, meaning they were developing individual conditions at both a higher frequency and speedier rate. Estrogen therapy was able to reduce some of the risk, but not all.
As for why this phenomenon might be occurring, the researchers suggested that the loss of estrogen from the ovarian removal triggered a cascade of aging mechanisms on both the cellular and tissue level across the body.
The study suggests that, unless they are at a high risk of ovarian cancer, premenopausal women face more risks than benefits from ovarian removal due to increased aging in the form of higher rates and accumulation of chronic health problems.
“Ovarian removal to prevent ovarian cancer should not be an option for premenopausal women, Mayo research finds,” Mayo Clinic web site, September 27, 2016; http://www.mayoclinicproceedings.org/pb/assets/raw/Health%20Advance/journals/jmcp/jmcp_pr91_9_5.pdf, last accessed September 30, 2016.
Scutti, S., “Study: Removing both ovaries speeds aging in premenopausal women,” CNN web site, last updated September 29, 2016; http://edition.cnn.com/2016/09/29/health/removing-both-ovaries-to-prevent-cancer/, last accessed September 30, 2016.