Personal, reproductive, and familial characteristics associated with bilateral oophorectomy in premenopausal women: A population-based case-control study

Abstract

Objectives: We investigated the association of personal, reproductive, and familial characteristics with bilateral oophorectomy performed for nonmalignant indications in a US population. Study design: In an established cohort study, we used the records-linkage system of the Rochester Epidemiology Project (REP http://www.rochesterproject.org) to identify 1,653 premenopausal women who underwent bilateral oophorectomy in Olmsted County, Minnesota between 1988 and 2007 for a nonmalignant indication. Each woman was matched by age (±1 year) to a population-based referent woman who had not undergone bilateral oophorectomy as of the index date. We used case-control analyses to investigate several characteristics associated with bilateral oophorectomy. Odds ratios and their 95% confidence intervals were adjusted for ethnicity, education, and income. Results: In the overall analyses, infertility was more common in women who underwent bilateral oophorectomy than in the controls, whereas use of oral contraceptives, a history of breast feeding, and fibrocystic breast disease were less common. The women who underwent bilateral oophorectomy weighed more than controls, had a higher body mass index and were older at menarche. The associations were more pronounced for women who underwent the bilateral oophorectomy before age 46 years, and some associations were different for women with or without a benign ovarian indication. Reported family histories of uterine and other cancers were more common in women without a benign ovarian indication. Conclusions: We identified a number of personal, reproductive, and familial characteristics that were associated with bilateral oophorectomy over a 20-year period. Our historical findings may help inform decision-making about oophorectomy in the future.

The association of age at menopause and all-cause and cause-specific mortality by race, postmenopausal hormone use, and smoking status

“…Induced early menopause may be due to surgical or medical interventions including bilateral oophorectomy, chemotherapy or radiation (Shuster et al, 2010). For example, some women undergo bilateral oophorectomy for ovarian cancer prophylaxis or for benign gynecological conditions (Melton III et al, 1991; Rocca et al, 2018; Shuster et al, 2008). Treatment for cancers such as breast or gynecologic may require medical interventions such as chemotherapy or irradiation that induce early menopause (Rosenberg and Partridge, 2013; Shuster et al, 2010).…”

Time Trends in Unilateral and Bilateral Oophorectomy in a Geographically Defined American Population

“…The pathology report was based on an evaluation by a pathologist of frozen ovarian sections at the time of surgical operation and on the subsequent confirmation on permanent sections. 28 – 30 The medical records abstractor categorized pathology as primary ovarian cancer, metastatic cancer, benign ovarian tumor (eg, cystadenoma, dermoid cyst, fibroma, teratoma), endometriosis, oophoritis, cyst, other inflammatory process (eg, abscess, adhesions), atrophy, or other ovarian lesions (eg, torsion, fibrosis, thecosis, endosalpingiosis, hemorrhage). Ovaries that had no pathologic diagnoses were labeled as “apparently normal.” Each ovary could have more than one pathologic finding.…”

“…A single pathology category was assigned to each unilateral or bilateral oophorectomy using the most severe pathology result found, according to the order presented above. 30 …”

Risk of de novo cancer after premenopausal bilateral oophorectomy

“…The indication and the pathology results for each bilateral oophorectomy were defined by the gynecologist and pathologist at the time of surgery. 23,24 In addition, we considered 16 of the 20 chronic conditions used by the DHHS to define multimorbidity and anxiety present at the index date (total of 17 conditions): depression, anxiety, substance abuse disorders, dementia, schizophrenia or psychosis, hyperlipidemia, hypertension, diabetes mellitus, cardiac arrhythmias, coronary artery disease, stroke, congestive heart failure, arthritis, asthma, chronic obstructive pulmonary disease, osteoporosis, and chronic kidney disease. 29 From the DHHS list we excluded cancer (study outcome), HIV, autism spectrum disorder, and hepatitis.…”

“…and Aging-2 (MOA-2) have been previously described. 19,20,23,24 Briefly, we included all premenopausal women who underwent bilateral oophorectomy between January 1, 1988 andDecember 31, 2007 in Olmsted County, Minnesota. We excluded women who underwent oophorectomy to treat ovarian cancer (primary or metastatic), to treat another estrogen-sensitive malignant disorder (usually breast cancer), or because they were considered at high risk of ovarian cancer (strong family history as judged by the gynecologist or carriers of BRCA1 or BRCA2 pathogenic variants).…”