April 5, 2006 — Ladies who experience ovary evacuation some time recently menopause may have an expanded risk of dementia, a Mayo Clinic think about proposes.
“What we are talking around is still-fertile women, finished with having children, who have a few occasion that leads to surgery to expel their uterus, and the surgeon evacuates one or both ovaries to prevent cancer,” ponder leader Walter Rocca, MD, MPH, tells WebMD.
The 2,511 women within the ponder had these operations between 1950 and 1987. The ladies were then coordinated with women who did not undergo ovary evacuation. Rocca’s team decided whether the women created dementia by meeting a family part or by giving the ladies a test by telephone.
“What we appeared is that for the surgery to be a risk calculate, it has got to be done before menopause,” Rocca says. “On the off chance that before age 46 you expel two ovaries, you get a 70% increased chance of dementia. And we found that women who have only one ovary evacuated before age 38 — this is often a surgery more often worn out younger women — we see a 260% increase in dementia. That is very a emotional and to some degree unforeseen finding.”
Rocca reported the findings at the annual assembly of the American Academy of Neurology in San Diego.
Rocca anticipates his discoveries to be disputable. And they are. One skeptic is Paul Norris, MD, executive of regenerative health at the University of Miami School of Medication. Norris did not go to the AAN meeting but surveyed the written theoretical of Rocca’s study and a Mayo Clinic news release.
“I am raising both eyebrows as I read this,” Norris tells WebMD. “There are a lot of reasons to keep the ovaries in, extending from heart wellbeing to vagina health. But there is just no sign that it makes a distinction in dementia.”
There’s, in any case, bolster for Rocca’s hypothesis. It comes from rat thinks about by Johns Hopkins neuropathologist Alena V. Savonenko, MD, PhD, and colleague Alicja Markowska, PhD, of the National Institute on Aging.
Savonenko and Markowska recently found that expelling the ovaries of middle-aged rats sped the animals’ age-related loss of mental function. Estrogen replacement — in the event that done on the correct plan — anticipated this impact.
“I was shocked to see that there was so much closeness between Dr. Rocca’s epidemiology ponder and our basic-science ponder in rats,” Savonenko tells WebMD. “Our rats were completely doing the same thing as these women.”
Still, Savonenko would be cautious in prompting women not to experience doctor-recommended ovary removal.
“I think there are very emotional reasons why women undergo this surgery,” she says. “I don’t think the possible side effects on [mental function] ought to hold women from essential ovary expulsion. But what I would suggest is thought of estrogen substitution treatment for this cohort of ladies, especially since there presently is this evidence of cognitive decrease.”
One reason Norris is doubtful of the Rocca study is that expulsion of one ovary had a much bigger effect than removing both ovaries.
“Why are women with one ovary taken out doing worse than those with both taken out? You’ve got to raise an eyebrow almost that,” he says.
Rocca suggests that the situation is more complicated than most analysts realize. He recommends that ladies who have the kinds of issues that result in hysterectomy — such as uterine fibroids or endometriosis — have a few fundamental imperfection within the way their bodies utilize estrogen.
In another consider he presented at the AAN assembly, Rocca found that ladies with Parkinson’s disease tend to have defects in certain estrogen-related genes. He suggests that women who carry these unordinary genes may be at higher hazard of dementia — and ovary expulsion essentially amplifies this risk.
“So the diversion is more complex than fair the issue of how much estrogen a woman’s ovaries are making,” Rocca says. “We will at some point be superior able to exhort the lady facing the surgeon and predict final balance between the advantage of preventing ovarian and breast cancer vs. the hazard of dementia, Parkinson’s infection, stroke, or heart assault. It is very complicated — but on the off chance that what we are seeing gets affirmed by others, in the future we may offer to the person woman a more shrewdly and informed premise to create a decision on ovary expulsion.”
Norris, be that as it may, says the Rocca think about offers far too little evidence for such predictions.
“I think he is out on a limb here,” he says.