Dementia and Parkinsonism
Women are so often told that if they are going to have a hysterectomy, they may as well have their ovaries removed. In fact, as many as 30% of women undergoing removal of the uterus are convinced to have their ovaries removed “just in case”.
In addition, removal of one or both ovaries is often performed for various benign conditions including ovarian cysts, endometriosis, and for the prevention of ovarian cancer. As with any medical procedure, it is always important to evaluate the “risk benefit ratio.” That is, is the benefit of a medical intervention worth the risk?
Two new reports published in the August 29, 2007 online issue of the journal, Neurology, raise some serious concerns about premenopausal ovary
removal. The first study followed 3000 women over an average of 27 years, half of whom underwent removal of one or both ovaries while the other half did not. Those women who had one or both ovaries removed before menopause had about a 200% increase in cognitive problems or dementia compared to those who still had their ovaries. The risk was especially high in those undergoing the surgery at a younger age.
Study author Walter A. Rocca, MD of the Mayo Clinic in Rochester, MN stated, “It’s possible that estrogen has a protective effect on the brain and lack of estrogen due to ovary removal may increase a woman’s risk of developing memory problems.”
In a related study, the risk of Parkinsonism was also increased by about two fold in women having had one or both ovaries removed before menopause. Again, Dr. Rocca speculated that estrogen is important for maintaining brain health stating ”these findings may be explained by a premature loss of estrogen and neuroprotection.”
These reports should cause women contemplating this surgery to pause and recognize that detrimental consequences of this procedure may occur many years after the actual procedure. Further, it may very well be that not all gynecological surgeons are aware of this new data. And, there is nothing at all wrong with bringing this to their attention.
Clearly,there are well defined circumstances in which removal of one or both ovaries is mandated, but the key is to define what is mandatory in light of this new information.