Increased mortality for neurological and mental diseases following early bilateral oophorectomy.
BACKGROUND
The effects of oophorectomy on brain aging remain uncertain.


METHODS
We conducted a cohort study with long-term follow-up of women in Olmsted County, Minn., USA, who underwent either unilateral or bilateral oophorectomy before the onset of menopause from 1950 through 1987. Each member of the oophorectomy cohort was matched by age to a referent woman from the same population who had not undergone any oophorectomy. We studied underlying and contributory causes of death in 1,274 women with unilateral oophorectomy, 1,091 women with bilateral oophorectomy, and 2,383 referent women.


RESULTS
Mortality for neurological or mental diseases was increased in women who underwent bilateral oophorectomy before age 45 years compared with referent women (hazard ratio = 5.24; 95% confidence interval = 2.02-13.6; p < 0.001). Within this age stratum, mortality was similar in women who were or were not treated with estrogen from the time of oophorectomy through age 45 years, and in women who had bilateral oophorectomy for prophylaxis or for treatment of a benign ovarian condition. Mortality was also increased in women who underwent unilateral oophorectomy before age 45 years without concurrent hysterectomy.


CONCLUSIONS
Bilateral oophorectomy performed before age 45 years is associated with increased mortality for neurological or mental diseases.
Division of Preventive and Occupational Medicine, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Cathleen M
CM
Rivera
Brandon R
BR
Grossardt
Deborah J
DJ
Rhodes
Walter A
WA
Rocca
D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000401:mortality; D007223:Infant; D001523:Mental Disorders / Q000401:mortality*; D009422:Nervous System Diseases / Q000401:mortality*; D010052:Ovariectomy / Q000401:mortality*; D017697:Premenopause; D016016:Proportional Hazards Models; D012307:Risk Factors; D055815:Young Adult