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Younger age at surgical menopause has neurological risk

Review on January 22, 2008

Surgical menopause may be associated with higher risks for estrogen-related cognitive impairment than natural menopause, a risk that is even greater in young women.

Drs. Henderson and Sherwin investigated the hypothesis by carrying out evidence-based research and reviewing the results of hormone-therapy trials. The investigators discovered that while natural menopause may not necessarily be associated with memory lapses and mental impairment, women who undergo surgical menopause suffer more often from cognitive degeneration, particularly in the area of "verbal episodic memory".

The risk for memory lapses and severe neurological illnesses is even greater for women who have undergone surgical menopause at a younger age, says a recent article published in Science News. Dr. Walter Rocca from the Mayo clinic led a team of investigators in a study of women who had undergone surgical ovary removal, or oophorectomy, during the years of 1950 to 1987.

676 of the subjects underwent complete oophorectomy, and 813 received the removal of one ovary. This group was compared with 1,471 "control" women who corresponded to the test subjects in age.

Interviews were conducted with the subjects and the controls to determine any diagnosis of Alzheimer's disease, dementia or other neurological illnesses, memory lapses, and/or impediments in daily living.

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150 of the subjects who had undergone partial or total ovary removal reported mental decline or dementia, as opposed to 98 women in the control group. Women who received oopherectomy before the age of 41 were also at a greater risk for illnesses similar to Parkinson's disease (parkinsonism), which cause mental and physical impairment.

The risk of mental deficit and neurological deficiency is age-related, the report concluded. Women who undergo surgical menopause at a younger age are at a much higher risk, although this may be alleviated by receiving estrogen replacement therapy. Rocca and his team thus conclude that estrogen may have a farther-reaching and more complex effect in the brain than previously suspected.

Conclusion: The researchers concluded that estrogen replacement therapy is most beneficial in helping to prevent or ameliorate cognitive impairments in oophorectomy patients before the age of 50.

Sources:
  • Early surgical menopause raises neurologic risk." Science News. August 29, 2007.
  • Henderson VW, Sherwin BB. "Surgical versus natural menopause: cognitive issues." Menopause. 2007 May-Jun;14(3 Pt 2):572-9.