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Bilateral oophorectomy may increase risk for diabetes
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Women who have hysterectomies accompanied by ovary removal surgery may be at increased risk for diabetes and other chronic diseases, according to study data.
The researchers evaluated 2,597 patients from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study, a longitudinal study of women aged 25 to 74 years who completed medical examination in the NHANES I. Women were asked about their menstrual cycles, whether they had gone through menopause and whether menopause was surgically induced or naturally occurring. Exclusions were made on the basis of unknown age at onset of menopause, unilateral oophorectomy, intact uterus but bilateral oophorectomy, missing weight measurement, "other" race/ethnicity, diabetes, cardiovascular disease and gynecological cancers.
At a median follow-up of 9.2 years, the rate of diabetes (in cases per 1,000 person-years) among women who had not had hysterectomy or bilateral oophorectomy was 7.4; the rate was 8.2 in those who had hysterectomy alone and 8.5 in those with hysterectomy accompanied by bilateral oophorectomy. There was a positive correlation between diabetes and hysterectomy status (HR=1.66; 95% CI, 1.23-2.23). After adjusting for relevant confounding factors, however, this increased risk was limited only to women with both hysterectomy and bilateral oophorectomy (HR=1.57; 95% CI, 1.03, 2.41). Younger menopausal age and shorter span of childbearing also were linearly related to diabetes, notwithstanding the type of menopause.
Because of this potential risk, concomitant oophorectomy and hysterectomy for benign conditions during premenopausal years should be weighed against the risk for diabetes, the study researchers said.
"The choice of prophylactic oophorectomy at the time of hysterectomy is a complex decision requiring that patients and physicians consider multiple factors," they wrote. "Recognizing that the preservation of the ovaries at the time of hysterectomy may greatly influence the long-term health of women, gynecologists are less likely nowadays to recommend prophylactic [bilateral oophorectomy] in younger women."
Disclosure: The researchers report no relevant financial disclosures.
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Appiah D. Diabetes Care. 2013; [published online ahead of print Nov. 5].
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