Women younger than 46, both ovaries had seen a significant increase of eight chronic diseases, including heart disease, depression, arthrit...
the medical records of women in relation to life in Olmsted County, Minnesota, the researchers identified those who bilateral oophorectomy had undergone: The removal of both ovaries.
"Overall, 1653 women underwent oophorectomy and also identifies an equal number of women of the same age, has not undergone castration," said Dr. Walter Rocca, senior author of the study, which was published in the journal Mayo Clinic Proceedings. "Then the rate compared to the 3,306 women over a mean follow-up period of 14 years."
To measure the rate of aging, Rocca and his co-authors examined the amount and type of disease, each woman.
The aging occurs at all levels within the organization, Rocca said, so that when the cells and organs begin to malfunction, signs and symptoms of the disease occur. "Therefore, it is believed that a woman with a younger age receives multiple diagnoses undergo accelerated aging," he said.
The analysis of the collected data and the comparison of two groups of women found Rocca that women under 46, the operation had undergone experienced a higher incidence of chronic diseases 18 (except cancer) and were more likely to have multiple chronic diseases.
However, estrogen therapy after surgery reduces the risk of certain diseases. The lack of estrogen can age in women, accelerate to Rocca.
Estrogen and Aging
The ovaries are almond large glands that meet a woman with her vital hormones, including the main sex hormone estrogen. Every month the right or left ovary produces a single mature egg for fertilization. To remove the ovaries of a young woman who wanted to move to the Menopause - the hinge of a woman's life, the moment is fertile.
Even after menopause, but they continue to produce ovarian hormones, including testosterone and androstenedione, which is then converted into the other cells in the body estrogen.
However, the doctor may recommend estrogen therapy after bilateral oophorectomy, many women do not interrupt or prematurely. Rocca says this is related to the difficulty and the cost of taking a drug for a decade or more.
But although women Recommendation are followed, "remain uncertain about the optimal dose" Doctors, Rocca said, or if a patch, for example, is better than a pill. Worse, hormone therapy does not address all the potential negative consequences of the operation, including depression, disease and glaucoma Parkinson.
"It is further proof that you should consider carefully whether the ovaries removed," said Dr. James Liu, chairman of the Department of Obstetrics and Gynecology of the University Hospitals of Cleveland Medical Center
The strength of the study, according to Liu, is that the two groups of women - those who had removed compared to those her ovaries that do not - were quite uniform.
Rocca and his colleagues represented every woman before surgery and diseases, and then said in the analysis noted Dr. William Parker, a clinical professor at the UCLA School of Medicine and director of the Mini- gynecology surgery in Santa Monica-UCLA Medical Center invasive ,
"So you could not use this as a reason to explain in the results, the differences," said Parker. "Said Rocca that possible criticism from the beginning."
Given the study both Liu and Parker have to settings bilateral oophorectomy have changed over time.
official guidelines
For nearly 35 years, most doctors recommend that women need to prevent also consider a hysterectomy ovarian ovarian cancer walk, Parker said.
Finally Ovarian cancer is particularly deadly - both difficult to detect and difficult to cure. In 2013, about 21,000 women in the United States she had ovarian cancer and 14.276 women died from it, according to the Centers for Disease Control and prevention of disease.
To these figures, most women who have a hysterectomy choose to have their ovaries removed at a time and, even if they were at average risk. Only Women carrying a BRCA mutation are drawn at high risk for ovarian cancer in consideration.
The current guidelines of the American College of Obstetricians and Gynecologists read: "The most effective way to prevent ovarian cancer, surgical removal of the ovaries and fallopian tubes is ... The potential benefits the risk of cancer in premenopausal women with an average risk of ovarian cancer in reducing the need. be balanced with the consequences of premature loss of estrogen production. "
Policy Group / GYN OB a word of warning is not added. strong consideration should be the maintenance of normal ovaries in premenopausal women are given which have an increased genetic risk for ovarian cancer. In practice, however, still recommend removal of both ovaries in premenopausal women with an average risk many doctors.
In Europe, the method for women is recommended at high risk from the age of 40, according to Murat Gultekin, Vice-President of the European Society of Gynecologic Oncology. However, the current practices from one center to another are different, he said.
The removal of both ovaries should not be a "humane option" for women to be taken into account that are not in the high risk group for cancer and are exposed, Rocca said in a statement. But it may take some time before the old practice faded into the past.
Liu agrees, "Now we understand how we do genotyping of ovarian cancer that most cancers is thought that arises only in the ovaries is indeed from the fallopian tube."
