Long-term risk of depressive and anxiety symptoms after early bilateral oophorectomy.
OBJECTIVE
We studied the long-term risk of depressive and anxiety symptoms in women who underwent bilateral oophorectomy before menopause.


METHODS
We conducted a cohort study among all women residing in Olmsted County, MN, who underwent bilateral oophorectomy before the onset of menopause for a noncancer indication from 1950 through 1987. Each member of the bilateral oophorectomy cohort was matched by age with a referent woman from the same population who had not undergone an oophorectomy. In total, we studied 666 women with bilateral oophorectomy and 673 referent women. Women were followed for a median of 24 years, and depressive and anxiety symptoms were assessed using a structured questionnaire via a direct or proxy telephone interview performed from 2001 through 2006.


RESULTS
Women who underwent bilateral oophorectomy before the onset of menopause had an increased risk of depressive symptoms diagnosed by a physician (hazard ratio = 1.54, 95% CI: 1.04-2.26, adjusted for age, education, and type of interview) and of anxiety symptoms (adjusted hazard ratio = 2.29, 95% CI: 1.33-3.95) compared with referent women. The findings remained consistent after excluding depressive or anxiety symptoms that first occurred within 10 years after oophorectomy. The associations were greater with younger age at oophorectomy but did not vary across indications for the oophorectomy. In addition, treatment with estrogen to age 50 years in women who underwent bilateral oophorectomy at younger ages did not modify the risk.


CONCLUSIONS
Bilateral oophorectomy performed before the onset of menopause is associated with an increased long-term risk of depressive and anxiety symptoms.
Rocca
Walter A
WA
Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA. rocca@mayo.edu
Grossardt
Brandon R
BR
Geda
Yonas E
YE
Gostout
Bobbie S
BS
Bower
James H
JH
Maraganore
Demetrius M
DM
de Andrade
Mariza
M
Melton
L Joseph
LJ
D000328:Adult; D000368:Aged; D000375:Aging / Q000523:psychology; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008593:Menopause / Q000523:psychology*; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D016017:Odds Ratio; D010052:Ovariectomy / Q000009:adverse effects* / Q000706:statistics & numerical data