Accelerated Accumulation of Multimorbidity After Bilateral Oophorectomy: A Population-Based Cohort Study.
OBJECTIVE
To study the association between bilateral oophorectomy and the rate of accumulation of multimorbidity.


METHODS
In this historical cohort study, the Rochester Epidemiology Project records-linkage system was used to identify all premenopausal women who underwent bilateral oophorectomy before age 50 years between January 1, 1988, and December 31, 2007, in Olmsted County, Minnesota. Each woman was randomly matched to a referent woman born in the same year (±1 year) who had not undergone bilateral oophorectomy. We studied the rate of accumulation of 18 common chronic conditions over a median of approximately 14 years of follow-up.


RESULTS
Although women who underwent bilateral oophorectomy already had a higher multimorbidity burden at the time of oophorectomy, they also experienced an increased risk of subsequent multimorbidity. After adjustments for 18 chronic conditions present at baseline, race/ethnicity, education, body mass index, smoking, age at baseline, and calendar year at baseline, women who underwent oophorectomy before age 46 years experienced an increased risk of depression, hyperlipidemia, cardiac arrhythmias, coronary artery disease, arthritis, asthma, chronic obstructive pulmonary disease, and osteoporosis. In addition, they experienced an accelerated rate of accumulation of the 18 chronic conditions considered together (hazard ratio, 1.22; 95% CI, 1.14-1.31; P<.001). Several of these associations were reduced in women who received estrogen therapy.


CONCLUSIONS
Bilateral oophorectomy is associated with a higher risk of multimorbidity, even after adjustment for conditions present at baseline and for several possible confounders. However, several of these associations were reduced in women who received estrogen therapy.
Division of Epidemiology, Mayo Clinic, Rochester, MN; Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Department of Neurology, Mayo Clinic, Rochester, MN; Women's Health Research Center, Mayo Clinic, Rochester, MN. Electronic address: Rocca@mayo.edu.
Walter A
WA
Rocca
Division of Epidemiology, Mayo Clinic, Rochester, MN.
Liliana
L
Gazzuola-Rocca
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
Carin Y
CY
Smith
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
Brandon R
BR
Grossardt
Women's Health Research Center, Mayo Clinic, Rochester, MN; Women's Health Clinic, Division of General Internal Medicine, Mayo Clinic, Rochester, MN.
Stephanie S
SS
Faubion
Women's Health Clinic, Division of General Internal Medicine, Mayo Clinic, Rochester, MN.
Lynne T
LT
Shuster
Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN.
James L
JL
Kirkland
Women's Health Research Center, Mayo Clinic, Rochester, MN; Department of Surgery, Mayo Clinic, Rochester, MN; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN.
Elizabeth A
EA
Stewart
Women's Health Research Center, Mayo Clinic, Rochester, MN; Department of Surgery, Mayo Clinic, Rochester, MN.
Virginia M
VM
Miller
D000367:Age Factors; D001007:Anxiety / Q000453:epidemiology; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D001168:Arthritis / Q000453:epidemiology; D001249:Asthma / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D016555:Matched-Pair Analysis; D008910:Minnesota / Q000453:epidemiology; D009369:Neoplasms / Q000453:epidemiology; D010024:Osteoporosis / Q000453:epidemiology; D010052:Ovariectomy; D017697:Premenopause; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology
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