Women who undergo bilateral oophorectomy, the surgical removal of both ovaries, face a significantly increased risk of developing heart failure later in life, according to a new study. The findings, presented at the American College of Cardiology’s Annual Scientific Session (ACC.25), highlight the long-term cardiovascular risks associated with this procedure, particularly when performed before natural menopause.
Impact of Oophorectomy on Cardiovascular Health
Bilateral oophorectomy is often performed to treat conditions like endometriosis, ovarian cancer, or pelvic inflammatory disease, and can prevent certain health issues. However, this procedure also causes a sudden drop in the production of estrogen and other hormones, which may induce early menopause. The timing of the procedure and the sudden hormonal changes it triggers may contribute to a distinct cardiovascular risk profile compared to other causes of early menopause.
According to Dr. Narathorn Kulthamrongsri, a first-year internal medicine resident at the University of Hawaii, the study suggests a strong connection between the removal of the ovaries and an increased risk of heart failure. “Sex hormones, including estrogen and progesterone, play a crucial role in cardiovascular health. Our study shows that early menopause caused by oophorectomy may be a unique contributor to heart failure risk,” said Dr. Kulthamrongsri.
Study Design and Results
The study used data from 6,814 female participants in the National Health and Nutrition Examination Survey (NHANES) collected between 2017 and 2023. The average age of women undergoing oophorectomy was 43.6 years, with heart failure diagnosed at an average age of 57. Researchers found that women who had both ovaries removed had a 1.5-fold increased risk of developing heart failure, even after adjusting for factors like age, race, smoking, diabetes, and high cholesterol. Notably, white women and those who underwent oophorectomy at younger ages exhibited a twofold increased risk of heart failure.
The study also revealed that the age at which a woman has her ovaries removed significantly impacts her risk of developing heart failure. “For each year later that a woman undergoes oophorectomy, the onset of heart failure is delayed by approximately 0.6 years,” said Dr. Kulthamrongsri.
Racial Disparities in Heart Failure Risk
The study also found a surprising racial disparity. White women had a significantly higher risk of heart failure after undergoing oophorectomy compared to women of other racial groups. This contrasts with previous research that shows Black women often experience worse heart failure outcomes due to higher rates of hypertension, diabetes, and obesity. White women tend to develop heart failure due to ischemic heart disease and lifestyle-related factors such as smoking and poor diet. Dr. Kulthamrongsri speculates that this disparity may be explained by the role of sex hormones in early surgical menopause and the heart failure etiology associated with myocardial infarction or other conditions.
Importance of Cardiovascular Monitoring
The study underscores the need for women to have informed discussions with their healthcare providers about the potential cardiovascular risks of oophorectomy, especially if it occurs before natural menopause. The researchers suggest that women considering the procedure should be made aware of the potential long-term cardiovascular implications, including heart failure risk, and take proactive steps to monitor and manage these risks.
Dr. Kulthamrongsri advises, “Women should engage in discussions with their healthcare team about how to monitor cardiovascular health and manage potential risk factors for heart failure. Lifestyle changes such as adopting a heart-healthy diet, exercising regularly, and considering hormone replacement therapy may be important components of this approach.”
Limitations and Future Research
While the study adds to a growing body of evidence on the cardiovascular consequences of early surgical menopause, it is limited by the reliance on self-reported data and the inability to establish the exact timing of heart failure development after the procedure. Further research using larger, more diverse datasets is needed to validate these findings and explore the potential preventive solutions.
In addition, future studies should investigate the role of cardiovascular screening and prophylactic heart medications for women who undergo oophorectomy to mitigate the risk of heart failure.
Conclusion
This study highlights the importance of recognizing the cardiovascular risks associated with bilateral oophorectomy, particularly in women who undergo the procedure before natural menopause. By understanding the long-term implications of early menopause caused by oophorectomy, healthcare providers can better guide women in making informed decisions about their health and ensure timely monitoring and intervention to reduce the risk of heart failure.
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