Premenopausal bilateral oophorectomy linked to risk for chronic conditions in midlife

Key takeaways:

• Premenopausal bilateral oophorectomy before age 46 years raised odds of arthritis, asthma, bone fractures and sleep apnea.
• Oophorectomy history also shortened 6-minute walking distance vs. controls.

A history of premenopausal bilateral oophorectomy, especially when younger than 46 years, increased the odds of arthritis, asthma, obstructive sleep apnea and bone fractures, researchers reported in Menopause.

“Studies of premenopausal bilateral oophorectomy with or without hysterectomy to date have primarily used passive collection of outcomes through medical record abstraction, diagnostic codes or hospital records,” Michelle M. Mielke, PhD, professor in the department of epidemiology and prevention at Wake Forest University School of Medicine, and colleagues wrote. “As a result, it is not clear whether specific domains of physical function or other aging-related measures are more affected than others.”

Mielke and colleagues evaluated data from 274 women aged 55 years or older with premenopausal bilateral oophorectomy with or without hysterectomy at the same time or beforehand. They were compared with data from 240 controls in the same age range. All participants were residents of Olmsted County, Minnesota. Researchers assessed chronic conditions through medical records, and cognitive diagnoses were based on neurocognitive testing.

Clinical visits were a median of 22 years after premenopausal bilateral oophorectomy or index date. Of women with premenopausal bilateral oophorectomy, 58.8% were younger than 46 years and 41.2% were aged 46 to 49 years at the time of oophorectomy. Of these women, 5.8% had a hysterectomy before oophorectomy, 90.9% had hysterectomy concurrently with oophorectomy and 3.3% did not have hysterectomy concurrently or before oophorectomy.

Women with premenopausal bilateral oophorectomy before age 46 years had increased odds of arthritis (OR = 1.64; 95% CI, 1.06-2.55), asthma (OR = 1.74; 95% CI, 1.03-2.93), obstructive sleep apnea (OR = 2; 95% CI, 1.23-3.26) and bone fractures (OR = 2.86; 95% CI, 1.17-6.98) compared with controls. In addition, women with such history walked a shorter mean distance during the 6-minute walk test compared with controls (P = .034).

Researchers also observed increased odds of arthritis (OR = 1.92; 95% CI, 1.16-3.18) and obstructive sleep apnea (OR = 2.21; 95% CI, 1.33-3.66) among women with premenopausal bilateral oophorectomy history at age 46 to 49 years compared with controls. Researchers noted no significant differences in cognitive status between women with premenopausal bilateral oophorectomy at any age and controls.

“Longitudinal studies with extended follow-up are needed to assess whether additional differences in cognitive and physical function emerge at older ages,” the researchers wrote. “In addition, patient registries are needed to study the trajectories of clinical course after premenopausal bilateral oophorectomy because it is possible that chronic conditions develop at different times with variable effects of estrogen therapy, aging and other factors.”