Pre-Menopausal Ovary Removal Linked With Dementia

By: Danae Roumis for Body1

Recent research published in the 29 August online issue of the journal Neurology suggests that removal of the ovaries (called oophorectomy) prior to the onset of menopause may greatly increase a woman’s risk of dementia, including Parkinson’s disease and memory loss. The earlier the ovaries are removed, the greater the risk: women who had one or both ovaries removed before 41 years of age were 75 percent more likely to suffer from impaired neurological function.

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The best way to be sure you receive appropriate and beneficial treatment is to be an informed consumer. If you are looking to treat ovarian cysts, endometriosis or another infection, there are alternatives to oophorectomy. If you are considering ovary removal, be sure to ask your physician about the full range of procedural and treatment details. Educate yourself about your condition, treatments, and their consequences. If you are experiencing any of the symptoms of Parkinsonism and you have undergone unilateral or bilateral oophorectomy, speak with your physician about your symptoms and possible avenues of treatment. Keep in mind that the effects of Hormone Replacement Therapy (HRT) differ depending on age and phases of the body. Generally, effects of estrogen therapy have been shown to be positive before menopause, especially following oophorectomy, and negative after the onset of menopause. Each case should be discussed on an individual basis with a doctor.

The ovaries’ main roles are to store and deliver eggs as well as to produce the hormone estrogen. Estrogen serves an important function in the protection of the brain. According to Dr. Kieran Breen, Director of Research and Development for the Parkinson's Disease Society, estrogen protects nerve cells against the effects of external toxins, which include nerve cell death and diseases such as Parkinson’s disease and Alzheimer’s disease.

This new research confirms the importance of the ovaries in the preservation of cognitive function with aging. Approximately 2,000 women in Olmsted County, Minnesota who had one or both of their ovaries removed between 1950 and 1987 were followed for an average of 27 years. About half of the participants had undergone oophorectomy because of endometriosis or cysts, and the others in a preventive effort against ovarian cancer. Each was interviewed about her records of Parkinsonism and the state of her memory. Parkinsonism refers to any condition that causes symptoms similar to Parkinson's disease. These include tremor, stiffness of the arms, legs or trunk of the body, loss of facial expression, loss of control over movement, paralysis, and cognitive dysfunction. In the end, those who had undergone pre-menopausal surgery demonstrated an increased chance of Parkinsonism, poor memory and even dementia.

The study also revealed that women who had bilateral oophorectomy (removal of both ovaries) before the age of 49 maintained their neurological function if they were given estrogen treatment through the age of 50, which is the typical age for the natural onset of menopause. Previous studies showed estrogen treatment in women 65 and older to be detrimental, often leading to heart disease, stroke, memory loss, dementia and even breast cancer. Researchers discovered that about 60 percent of women received estrogen treatment following oophorectomy, yet only 20 percent of them followed the treatment through age 50. These findings suggest that there may be a critical age window during which the brain is protected by estrogen. Dr. Walter Rocca, epidemiologist and neurologist of the Mayo Clinic in Rochester, Minnesota and leader of the research, believes that the advantages of estrogen supplementation are age-dependent. In what he refers to as the ‘time-window effect,’ estrogen given at one age is protective, while at another age it becomes harmful. What’s left to be studied is the effect of estrogen supplements in women between 50 and 65 years old.

In the United States, hundreds of thousands of women undergo ovary removal each year. Dr. Rocca believes that significantly fewer procedures should be done. All women should initiate a discussion with their physicians if they are considering ovary removal, or seeking pre- or post-menopausal treatment options.

Last updated: 04-Sep-07