Spinal Decompression

Ovarian and Dementia Risk

Many women have to face a very difficult decision to electively remove their ovaries because of an inherited ovarian cancer risk.

But now the findings of new research are making that decision a bit more difficult.

Mayo Clinic researchers have found that surgically removing a woman’s ovaries raises her risk of developing dementia or cognitive impairment later on.

Women who had removal of one or both ovaries were compared with women who had no surgery.

All were followed over time to see whether they developed dementia or cognitive impairment.

They found a roughly one and a half times increased risk of dementia with surgery—which was especially increased if a woman has her ovaries removed at a young age-- before age 46, or one ovary before age 38.

Dr. Alberte Favate, a neurologist at St. Vincent’s Hospital, says, “Estrogen may have a neuro-protective effect in some cases for certain disease processes such as certain dementia and possibly even Alzheimer’s disease // meaning the nerve cells in the brain itself are actually protected against the risk of having a degenerative process like dementia in the presence of normal or slightly increased levels of estrogen.”

The authors proposes two possible theories to explain the increased risk:

Either that low estrogen due to the ovary removal leads to decreased protection of a woman’s brain from cognitive decline, or it’s not the surgery, but rather that variations in the genes a woman is born with dictate the need for ovary removal and also prompt development of dementia or cognitive impairment.

The authors say the study’s findings must be discussed by those contemplating elective ovary removal—for example, to reduce the risk of ovarian cancer.

But other experts disagree.

Dr. Sanford Lederman, the interim chair of the OB-GYN department at Long Island College Hospital, says, “I am quite concerned about the number of patients that were involved, it is much to small of a study to make any recommendations on the basis.//If there is an indication to remove the ovaries or do a oophorectomy that should take precedence over the concern of the development of dementia or Alzheimer’s related to the lack of estrogen.”

Now, prevention of dementia used to be one of the reasons to give estrogen after the menopause…to keep brain function intact.

But this hasn’t been borne out in studies to be of benefit.

“We were hoping there would be benefits for cognitive changes, again we did not see any studies recently that show that there is benefit to estrogen replacement and long term therapy,” Dr. Lederman states.

So what can be done, if not estrogen is to live a heart healthy lifestyle.

“There is a significant amount of dementia in the united states and western developed countries that is a direct result from stroke and high blood pressure and diabetes which are big risk factors so if you modify those risk factors you indirectly modify your chance of having dementia from those causes,” says Dr. Favate.

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