The long-term association between bilateral oophorectomy and depression: a prospective cohort study

Abstract

Objective: Depression is a leading cause of disability globally and affects more women than men. Ovarian sex steroids are thought to modify depression risk in women and interventions such as bilateral oophorectomy that permanently change the sex steroid milieu may increase the risk of depression. This study aimed to investigate the associations between unilateral and bilateral oophorectomy and depression over a 25-year period (1993-2018) and whether this varied by age at oophorectomy or use of menopausal hormone therapy.Methods: Twenty-five thousand one hundred eighty-eight nurses aged !45 years from the Danish Nurse Cohort were included. Nurses with depression prior to baseline were excluded. Poisson regression models, with logtransformed person-years as offset, were used to assess the associations between oophorectomy and incident depression. Nurses who retained their ovaries were the reference group.Results: Compared with nurses with retained ovaries, bilateral oophorectomy was associated with a slightly higher rate of depression (rate ratio [RR], 1.08; 95% confidence interval [CI], 0.95-1.23), but without statistical significance. However, when stratified by age at oophorectomy, compared with nurses with retained ovaries, bilateral oophorectomy at age !51 years was associated with higher rates of depression (RR 1.16; 95% CI, 1.00-1.34), but not bilateral oophorectomy at age <51 years (RR 0.86; 95% CI, 0.69-1.07); P value for difference in estimates ¼ 0.02. No association between unilateral oophorectomy and depression was observed.Conclusions: In this cohort of Danish female nurses, bilateral oophorectomy at age !51 years, but not at younger ages, was associated with a slightly higher rate of depression compared with those who retained their ovaries.

Risk of Fracture After Bilateral Oophorectomy

“…1). (32)(33)(34)(35)(36)(37) At study entry, the included nurses completed a selfadministered questionnaire with information on lifestyle, selfreported height and weight, and previous and current use of HT. The self-reported HT use has previously been validated, and researchers found high to moderate sensitivity (78.4%) and specificity (98.4%) of self-reported use of HT compared with registration in the Danish Prescription Registry.…”

The intersection between menopause and depression: overview of research using animal models

“…Different studies have found that the patient’s age at the time of surgery, the type of surgery (uni- or bilateral), and additional extirpation of the uterus all modulate the risk of depressive symptoms. Thus, women who were younger at the time of surgery ( 25 ), in addition to women older than 51 years ( 26 ), were both found to exhibit a higher risk of affective symptoms, while an increased risk for depression (syndromic) and complaints in general health are registered in women subjected to the extirpation of the uterus and ovaries ( 27 ).…”