Bilateral Oophorectomy and Accelerated Aging: Cause or Effect?
BACKGROUND
The cause-effect relationship between bilateral oophorectomy and accelerated aging remains controversial. We conducted new analyses to further address this controversy.


METHODS
The Rochester Epidemiology Project records-linkage system was used to identify all premenopausal women who underwent bilateral oophorectomy for a noncancerous condition before age 50 years between 1988 and 2007 in Olmsted County, MN. 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 (historical cohort study). Analyses were restricted to women free of any of the 18 chronic conditions at the time of oophorectomy (or index date).


RESULTS
After adjustments for race/ethnicity, education, body mass index, smoking, and age and calendar year at the index date, women who underwent oophorectomy before age 46 years experienced an accelerated rate of accumulation of the 18 chronic conditions considered together (hazard ratio = 1.24; 95% confidence interval: 1.12, 1.37; p < .001). The single-year incidence rate of new conditions was most different in the first 6 years after oophorectomy but the difference attenuated thereafter. Findings did not vary by surgical indication for the oophorectomy.


CONCLUSIONS
Bilateral oophorectomy is associated with a higher risk of multimorbidity among women who did not have any of the 18 selected conditions at baseline. The association did not vary by surgical indication for oophorectomy. Our findings suggest that bilateral oophorectomy is causally linked to accelerated aging.
Division of Epidemiology, Department of Health Sciences Research.|Department of Neurology.|Women's Health Research Center.
Walter A
WA
Rocca
Division of Epidemiology, Department of Health Sciences Research.
Liliana
L
Gazzuola Rocca
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research.
Carin Y
CY
Smith
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research.
Brandon R
BR
Grossardt
Women's Health Research Center.|Women's Health Clinic, Division of General Internal Medicine.
Stephanie S
SS
Faubion
Women's Health Clinic, Division of General Internal Medicine.
Lynne T
LT
Shuster
Robert and Arlene Kogod Center on Aging.
James L
JL
Kirkland
Women's Health Research Center.|Department of Surgery.|Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota.
Elizabeth A
EA
Stewart
Women's Health Research Center.|Department of Surgery.
Virginia M
VM
Miller
D000328:Adult; D000367:Age Factors; D000375:Aging; D015897:Comorbidity; D005260:Female; D006801:Humans; D008875:Middle Aged; D008910:Minnesota; D010052:Ovariectomy; D017697:Premenopause; D011897:Random Allocation; D012307:Risk Factors
Accelerated aging; Bilateral oophorectomy; Cohort study; Estrogen therapy; Multimorbidity