Early removal of ovaries, particularly before the age of 40 may affect women's brain health, a recent study revealed.
Researchers have discovered that women who undergo oophorectomy before menopause may face a higher risk of experiencing reduced white matter integrity in their brains as they age.
White matter integrity refers to the condition and functionality of the white matter, which is the nerve fibers or axons in the brain. Reduction in white matter integrity is typically seen with aging and in people with conditions such as sclerosis, and stroke. It is also associated with cognitive impairments and various neurological issues.
"We know that having both ovaries removed before natural menopause causes abrupt endocrine dysfunction, which increases the risk of cognitive impairment and dementia. But few neuroimaging studies have been conducted to better understand the underlying mechanisms," said a study author, Michelle Mielke from the Wake Forest University School of Medicine in a news release.
The research team arrived at the findings after analyzing data from the Mayo Clinic Study of Aging, which included women over 50 and utilized diffusion tensor imaging, an MRI technique that measures the brain's white matter.
The study included 22 participants who had premenopausal bilateral oophorectomy (PBO)– the removal of both ovaries – before the age of 40, 43 participants who had PBO between ages 40 and 45, 39 participants who had PBO between ages 46 and 49, and 907 participants who did not have PBO before age 50.
The researchers noted that those participants with PBO before 40 had significantly reduced white matter integrity in multiple regions of the brain. Although there were similar trends with both the other groups, many of the results were not statistically significant.
Since approximately 80% of participants had a history of estrogen replacement therapy following oophorectomy, the researchers were unable to assess whether the use of estrogen replacement therapy after PBO reduced its impact on white matter integrity.
The researchers caution that further studies are required to understand how white matter changes are associated with cognitive impairment.
"While these findings are important for women to consider before having premenopausal bilateral oophorectomy for non-cancerous conditions, we need a larger and more diverse cohort of women to validate these results," Mielke said.
"Having both ovaries removed results in an abrupt decrease in both estrogen and testosterone in women. Therefore, one possible explanation for our results is the loss of both estrogen and testosterone," Mielke added.
