Oophorectomy is the surgical removal of the female reproductive organs—the ovaries. The ovaries produce the female sex hormones and regulate the reproductive and menstrual health of the women. Needless to say, the removal of the ovaries brings about a big change in the life of women and is by no means an easy decision to make. Before deciding whether to go for it or not, the healthcare provider like Best Gynecologist in Islamabad weighs the pros and cons and informs the patient about long-term side effects of oophorectomy. To know what exactly these long-term side effects are, read on:
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The Hormone Levels Drop Post-Surgery
Ovaries produce the hormones estrogen, progesterone and testosterone. All these hormones play an integral role in regulating the bodily functions. Without these hormones, particularly with their sudden depletion, as seen in oophorectomy, the health consequences are severe. There is increased risk of osteoporosis, sexual dysfunction, coronary artery disease, cognitive decline, mood disorders and stroke.
According to Philip Sarrel, MD, president of Advancing Healthy After Hysterectomy Foundation and professor emeritus of reproductive sciences and psychiatry at Yale, women with oophorectomy by the age of 35 years have seven times the risk of cardiovascular disorders, eight times the risk of getting a heart attack and twice the risk of dementia or cognitive impairment.
You May Need Hormone Replacement Therapy
Because of the aforementioned risks, experts believe that introduction of exogenous hormones—in the form of combined estrogen and progesterone pills—some risk can be mitigated.
Dr Matthew T. Siedhoff, gynecological surgeon in Los Angeles recommends that women who have undergone oophorectomy in their 30s or 40s should take hormone replacement therapy at least until they are closer to the natural age of menopause—about 51 years.
The timing of starting hormone replacement therapy is of utmost importance, because for the older individuals, hormone replacement poses its own risks. For younger individuals, hormone therapy can be started immediately after or before the oophorectomy to prevent acute hormone withdrawal.
That being said, not everyone is a candidate for hormone replacement therapy, and only complete assessment by a healthcare provider can establish the safety of taking exogenous hormones. For women who do start hormone replacement therapy, continuous follow-up with the gynecologist is a must to regulate and monitor the serum hormone levels.
Effect on Brain Health
The normal age of menopause ranges between 45 and 51 years, but for women undergoing oophorectomy, there is immediate menopause. In the Mayo Clinic Cohort Study of Oophorectomy and Aging, oophorectomy-induced-menopause was found to cause cognitive disturbances in women. Such women experienced higher long-term risk of dementia, depression, anxiety, parkinsonism and other neurological disorders.
The possible mechanisms can be sudden reduction in the levels of circulating estrogen, progesterone and testosterone. This can also be due to the chain of causality through increased serum gonadotropins—luteinizing hormone (LH) and follicle stimulating hormone (FSH)—released by the pituitary gland in the brain. Alternatively, this may be due to antagonistic or synergistic interaction of genetic variants like ESR1 gene with bilateral oophorectomy. More research and testing is needed on these possible mechanisms.
Oophorectomy May be Unilateral as Well
Oophorectomy can also involve removal of one diseased ovary as well. In this case, even one ovary is enough to avoid changes in the hormonal levels and fertility potential.
Get Help to Cope
No surgery is easy. If you underwent oophorectomy for any reason, know that its normal to feel overwhelmed by a myriad of emotions. After the surgery, expect to feel worried, anxious, irritable and even depressed. During this time, remember to be kind to yourself, and if need be, get help from a mental health professional, reachable at oladoc.com.