Highlights
- •The trajectories of metabolic parameters after bilateral oophorectomy remain unknown.
- •Weight, body mass index (BMI), and high-density lipoprotein cholesterol (HDL-C) changed significantly over a 10-year period after surgery.
- •The unfavorable changes in metabolic parameters occurred primarily within 4–5 years after surgery.
- •Some of these changes can be reduced in magnitude by estrogen therapy.
- •Our findings may inform the clinical management of women after bilateral oophorectomy.
Abstract
Objective
To study the trajectories of metabolic parameters after bilateral oophorectomy.
Study design
This population-based cohort study included a random sample of all premenopausal women
who underwent bilateral oophorectomy at or before age 45 years from 1988 to 2007 in
Olmsted County, Minnesota, and their age-matched (±1 year) referent women who did
not undergo bilateral oophorectomy.
Main outcome measures
The medical records of all women were reviewed to collect the metabolic parameters
over a 10-year period. We compared three groups of women: 1) referent women (n = 270),
2) women who underwent bilateral oophorectomy and received estrogen therapy (n = 163),
and 3) women who underwent bilateral oophorectomy and did not receive estrogen therapy
(n = 107).
Results
Over 10 years of follow-up, the three groups had significantly different mean values
of diastolic blood pressure, weight, body mass index (BMI), total cholesterol, triglycerides,
and high-density lipoprotein cholesterol (HDL-C). However, women with and without
bilateral oophorectomy were already different at baseline for hyperlipidemia, systolic
blood pressure, weight, and BMI. Nevertheless, the trajectories of change over 10 years
were significant for weight (group by time interaction p = 0.03), BMI (p = 0.03),
and HDL-C (p = 0.004). The changes occurred primarily in the initial 4–5 years. Women
who received estrogen therapy after bilateral oophorectomy were comparable to the
referent women with respect to the weight and BMI trends, and they experienced an
increase in HDL-C over time.
Conclusion
Women who underwent bilateral oophorectomy before menopause experienced unfavorable
changes in some metabolic parameters possibly increasing their cardiovascular risk.
Abbreviations:
CAD (coronary artery disease), ET (estrogen therapy), MOA-2 (Mayo Clinic Cohort Study of Oophorectomy and Aging-2), REP (Rochester Epidemiology Project), LDL-C (low-density lipoprotein cholesterol), HDL-C (high-density lipoprotein cholesterol), BMI (body mass index), GEE (generalized estimating equation)Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to MaturitasAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Accelerated accumulation of multimorbidity after bilateral oophorectomy: a population-based cohort study.Mayo Clin. Proc. 2016; 91: 1577-1589
- Increased cardiovascular mortality after early bilateral oophorectomy.Menopause. 2009; 16: 15-23
- Association of premature natural and surgical menopause with incident cardiovascular disease.JAMA. 2019; 322: 2411-2421
- Premature ovarian insufficiency: an International Menopause Society white paper.Climacteric. 2020; 23: 426-446
- Duration of reproductive life span, age at menarche, and age at menopause are associated with risk of cardiovascular disease in women.J. Am. Heart Assoc. 2017; 6
- Association of age at onset of menopause and time since onset of menopause with cardiovascular outcomes, intermediate vascular traits, and all-cause mortality: a systematic review and meta-analysis.JAMA Cardiol. 2016; 1: 767-776
- Metabolic syndrome after risk-reducing salpingo-oophorectomy in women at high risk for hereditary breast ovarian cancer: a controlled observational study.Eur. J. Cancer. 2009; 45: 82-89
- Longitudinal changes in abdominal fat distribution with menopause.Metabolism. 2009; 58: 311-315
- Bilateral oophorectomy and accelerated aging: cause or effect?.J. Gerontol. A Biol. Sci. Med. Sci. 2017; 72: 1213-1217
- Cohort profile: the Mayo Clinic Cohort Study of Oophorectomy and Aging-2 (MOA-2) in Olmsted County, Minnesota (USA).BMJ Open. 2017; 7e018861
- Personal, reproductive, and familial characteristics associated with bilateral oophorectomy in premenopausal women: a population-based case-control study.Maturitas. 2018; 117: 64-77
- History of the Rochester Epidemiology Project: half a century of medical records linkage in a US population.Mayo Clin. Proc. 2012; 87: 1202-1213
- Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project.Mayo Clin. Proc. 2012; 87: 151-160
- Data resource profile: the Rochester Epidemiology Project (REP) medical records-linkage system.Int. J. Epidemiol. 2012; 41: 1614-1624
- Use of a medical records linkage system to enumerate a dynamic population over time: the Rochester Epidemiology Project.Am. J. Epidemiol. 2011; 173: 1059-1068
- Framework for the treatment and reporting of missing data in observational studies: the Treatment And Reporting of Missing data in Observational Studies framework.J. Clin. Epidemiol. 2021; 134: 79-88
- Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient data.Lancet Public Health. 2019; 4: e553-e564
- Cardiovascular disease risk in women with premature ovarian insufficiency: A systematic review and meta-analysis.Eur J Prev Cardiol. 2016; 23: 178-186
- 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.Circulation. 2019; 140: e596-e646
- Identification of female-specific risk enhancers throughout the lifespan of women to improve cardiovascular disease prevention.Am. J. Prev. Cardiol. 2020; 2100028
- Unique cardiovascular risk factors in women.Heart. 2019; 105: 1656-1660
- Premature ovarian insufficiency and long-term health consequences.Curr. Vasc. Pharmacol. 2019; 17: 604-609
- Long-term safety of drospirenone-estradiol for hormone therapy: a randomized, double-blind, multicenter trial.Menopause. 2005; 12: 716-727
- Choosing an oestrogen replacement therapy in young adult women with Turner syndrome.Clin. Endocrinol. 2001; 54: 159-164
- Impaired endothelial function in young women with premature ovarian failure: normalization with hormone therapy.J. Clin. Endocrinol. Metab. 2004; 89: 3907-3913
Article info
Publication history
Published online: July 21, 2022
Accepted:
July 9,
2022
Received in revised form:
June 27,
2022
Received:
October 26,
2021
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
