Oophorectomy (the surgical removal of a woman’s ovaries) is a procedure women may opt to undergo for a number of reasons, including severe endometriosis, pelvic disease, or as a way to help prevent breast cancer. However, a recent study shows that oophorectomy before age 45 drastically increases a woman’s risk of osteoporosis. Here are some factors you should evaluate if you’re considering an oophorectomy.
Several years ago, as one of the expert patients at HealthCentral’s breast cancer site, I helped a woman through a difficult decision: at age 38, should she have her ovaries removed in order to reduce her system’s circulating estrogen - which had the potential to encourage a recurrence of her estrogen-receptive breast cancer?
Much to this woman’s credit, she realized that ovary removal at such a young age wasn’t something to be taken lightly. Yes, she had two children; no, she wasn’t contemplating adding to her family. But ovaries do more than grow eggs, and release them monthly; they’re a prime source of estrogen, the primary female sex hormone.
Yes, and"? Estrogen is responsible for so many positive health benefits, it’s no wonder it’s been called the "fountain of youth" hormone. Estrogen helps keep our skin soft, elastic, and unlined; joints supple; hair thick and shiny; and cholesterol at its optimum levels. It helps create sex drive, and keeps vaginal walls thick and elastic, making sex pleasurable rather than painful.
Estrogen also contributes to optimum brain function - and keeps your crazier emotions in check. You’ve heard about (and probably experienced) the wild mood swings and occasional depression of PMS (pre-menstrual syndrome), right? That’s the result of a sharp drop in estrogen levels just before your period.
Finally, estrogen helps prevent bone loss, and works with vitamin D and calcium to encourage bone growth. In other words - it helps prevent osteoporosis.
Pretty good stuff, eh? Unfortunately, when you lose your ovaries, you lose your chief source of estrogen - and its benefits listed above.
Up until several years ago, it was common for women who’d lost their ovaries - whether by surgery, or naturally, due to menopause - to replace their lost estrogen with hormone replacement therapy (HRT): a daily estrogen (or estrogen/progestin) pill. Many women stayed on HRT for years, even decades.
But several years ago, a wide-ranging, long-term study, the Women’s Health Initiative, released data showing that long-term HRT could actually be linked to increased rates of dementia, heart disease, blood clots, stroke, and breast cancer.
As a result, millions of women stopped taking their replacement estrogen - and put themselves at increased risk for osteoporosis.
But how great was that risk, actually?
A study released last month pegs osteoporosis risk for women who lose their ovaries before age 45, and don’t undergo HRT, at more than double that of women with functioning ovaries. In fact, the study notes a "2.92-fold increased likelihood of osteoporosis" - which is a nearly 300% increase.
So, what’s the bottom line here?
If you’re experiencing a health challenge that may lead to removal of your ovaries, think hard about risks and benefits.
Are you contemplating oophorectomy simply because you have endometriosis, even if you don’t find it that difficult to deal with?
Are you a younger woman with breast cancer whose risk of recurrence is fairly low?
In other words, is the loss of your ovaries, and estrogen’s many benefits - including bone health - truly worth it?
Only you can make this tough decision. And you may decide yes, I want to reduce my risk of breast cancer as much as humanly possible. Or yes, I can’t stand the pain of endometriosis any longer.
Just make sure you’ve considered all the facts before you act.
PJ Hamel is senior digital content editor and food writer at King Arthur Flour, and a James Beard award-winning author. A 16-year breast cancer survivor, her passion is helping women through this devastating disease. She manages a large and active online survivor support network based at her local hospital and shares her wisdom and experience with the greater community via HealthCentral.com.