title: Postmenopausal bilateral oophorectomy is not associated with increased fracture risk in older women.
abstract: We studied whether oophorectomy performed after menopause is associated with an increased risk of hip or vertebral fractures in 6295 Study of Osteoporotic Fractures participants. There was no association between postmenopausal oophorectomy and the risk of hip or vertebral fractures.
  
  
  BACKGROUND
  Bilateral oophorectomy after natural menopause has been associated with an increased risk of osteoporotic fractures, potentially because of a decline in serum estradiol and testosterone levels after the oophorectomy. We prospectively tested this hypothesis in the Study of Osteoporotic Fractures (SOF).
  
  
  METHODS
  We studied 6295 white women 65 years of age participating in the SOF who were not taking estrogen therapy at baseline. Hip fracture analyses included 708 hip fractures; vertebral fracture analyses included 267 incident vertebral fractures. Baseline serum estradiol and free testosterone values were available in a small subset of participants.
  
  
  CONCLUSIONS
  There were no significant differences in age, weight, or BMD between the women who underwent postmenopausal oophorectomy (n = 583) and those who did not (n = 5712). Free testosterone levels were significantly lower among women who had a postmenopausal oophorectomy. A history of postmenopausal oophorectomy was not associated with an increased risk of hip (hazard ratio [HR] = 1.1; 95% CI = 0.9-1.5) or vertebral fracture (HR = 0.7; 95% CI = 0.5-1.2). The relationship between oophorectomy and hip fracture was not altered by adding serum estradiol level (HR = 1.3; 95% CI = 0.5-3.2) or serum free testosterone level (HR = 1.7; 95% CI = 0.8-3.7) to the model. In summary, postmenopausal oophorectomy was not associated with an increased risk of hip or vertebral fracture in this cohort. These results are in contrast to previous findings, suggesting that the relationship between postmenopausal oophorectomy and fractures is not fully elucidated and that incidental oophorectomy after menopause should still be considered carefully in each potential patient.
authors.affiliation: Division of Endocrinology, Department of Medicine, University of California, San Francisco, California 94105, USA. dantoniucci@psg.ucsf.edu
authors.forename: Diana M
authors.initials: DM
authors.lastname: Antoniucci
authors.forename: Deborah E
authors.initials: DE
authors.lastname: Sellmeyer
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Schneider
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Vesco
authors.forename: Steven R
authors.initials: SR
authors.lastname: Cummings
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Melton
mesh_terms: D000368:Aged; D001835:Body Weight; D015519:Bone Density; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015999:Multivariate Analysis; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology / Q000209:etiology; D010052:Ovariectomy / Q000009:adverse effects*; D017698:Postmenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D013739:Testosterone / Q000097:blood; D013997:Time Factors
chemical_list: D013739:Testosterone; D004958:Estradiol