Removing Ovaries Before Menopause Leads to Memory, Movement
Troubles
Hormone-replacement therapy seems to lessen likelihood of problems,
study finds
By Amanda Gardner
HealthDay Reporter
WEDNESDAY, Aug. 29 (HealthDay News) -- Removing one or both ovaries
before a woman reaches natural menopause increases the risk of both
dementia and movement disorders such as Parkinson's disease.
But giving hormone-replacement therapy at least until the age of 50
blunts that risk, according to a study by Mayo Clinic researchers.
"It's the first study that shows that taking out the major source of
endogenous estrogen, which is ovaries, will have this impact on
movement disorders and one of the first with dementia," said Farida
Sohrabji, an associate professor of neuroscience and experimental
therapeutics at Texas A&M Health Science Center College of Medicine.
The study findings were published in the Aug. 29 online issue of
Neurology.
A woman's ovaries are her main source of endogenous (produced by the
body) estrogen.
There has been some evidence that estrogen can protect against
cognitive decline, although the landmark Women's Health Initiative (WHI)
study actually showed the opposite for women aged 65 and older.
The authors of the new study used the Rochester Epidemiology Project, a
database of records dating from 1935 housed at the Mayo Clinic in
Rochester, Minn, to identify all women in Olmsted County, Minn., who
had had one or both ovaries removed between 1950 and 1987. These
women were then compared to a control group. Each group consisted of
about 1,500 women.
The researchers then interviewed women in both groups (or their
relatives) to assess any degree of cognitive impairment or dementia, and
compared the two groups. Women who were still alive also underwent a
cognitive test over the phone.
Those women who had had one or both ovaries removed before
menopause were almost twice as likely to develop cognitive problems or
dementia, compared with women who did not have this surgery, known
as oophorectomy.
Women who were younger when they underwent oophorectomy were
more likely to develop dementia than women who were older at the time
of the surgery. The removal of ovaries is often done to protect women at
high risk of breast or ovarian cancer.
According to the study authors, women and doctors should think twice
before going ahead with such a surgery.
There has also been some evidence that estrogen helps protect against
movement disorders, although some studies have shown that the
hormone might be detrimental.
To assess this risk, the same set of Mayo Clinic researchers looked at
many of the same women involved in the dementia study. This group
included more than 2,000 women who had had one or both ovaries
removed, and a similar control group of women.
Women who had undergone a unilateral or bilateral oophorectomy (one or
both ovaries, respectively) before the onset of menopause were again
almost twice as likely to develop Parkinsonism, a syndrome involving
movement and muscle problems, the most common form of which is
Parkinson's disease.
Again, the younger the woman was when she had her ovary or ovaries
removed, the greater the chance she would develop a movement disorder.
The findings do need to be replicated, the study authors cautioned.
With hormones, timing may be everything.
"What seemed to matter was the length of time that women were exposed
to hormone therapy," Sohrabji said. "The shorter that duration, the more
likely they were to show dementia and movement disorders, and that's
consistent with the idea that there's a critical period for hormone therapy.
It also goes very well with data that recently emerged from the WHI
regarding cardiovascular risk being much less in women who took
estrogen earlier."
"All of these studies seem to be definitely pointing that there is a critical
window for hormone therapy," she continued. "It speaks both to a critical
[time] window and a critical duration."
More information
Learn more about ovary removal from the Mayo Clinic.
SOURCES: Farida Sohrabji, Ph.D., associate professor, neuroscience and
experimental therapeutics, Texas A&M Health Science Center College of
Medicine; Aug. 29, 2007, Neurology, online
Copyright © 2007 ScoutNews, LLC. All rights reserved.
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This is fascinating. Ties in to all the endocrine stuff we go thru.
I'm probably the only person on this board all for HRT. I saw what not taking it did to my mom. Her osteo really accelerated.
Pip
Hey Pip, I would love to hear more about your mom, I had a hysterectomy at 18 and have never taken any hormone replacement. it would be interesting to know what happen to someone else.
Rusty
Mom really blames all her osteo problems on not taking HRT when she started menapause. Her knees went really bad really quickly (within 2 years) and because she refused to have the surgery to replace them it spread into her back. She is adamant both my sister and I not make the same mistake she made.
To be fair - mom tried to do natural replacement - and I would not be surprised if she didn't follow the 'rules' and jumped around on what she was doing. Mom has a tendency to do what is best for the pocket book; not her body. Very 'depression era'.
So...fast forward a decade or two and that heart attack/HRT study came out. When everybody was going nuts and getting off HRT I listened to this fascinating discussion on it on NPR. Basically, they had a bunch of scientist types trying to tell people why the study got stopped in the middle and how it wasn't as bad as the media was portraying. Gee, where have we heard that before. So, at the time I thought when I need the info I'll do the research and see what I think of it.
Meanwhile - the links to myco's and heart disease surfaced as well as IBS (Mom has both bad) and I just think she might be right about the endocrine connection even if she is wrong about what started it. I've seen a ton of posts as well as research linking estrogen levels to AI disease.
Did I answer the question or just ramble?
Pip
Thanks pip, Yes you did answer my ? .
As for as I know, I never had any problem afterwards, I never went back after last check-up 6 weeks after surgery. Next time I went to a Doctor was 22 years later when I found out I had RA. Never was one to go to Doc. or take meds now it's all I do....LOL
This is truly fascinating. I've read lots of info and feel that my RA was helped along by the trauma to my body of having an emergency hysterectomy in Jun 2002 and 12 weeks later having major back surgery (lower back looks like a micano set). I do have both my ovaries though, they are not keen on taking them out at all unless they have to in the UK. My mum had an hysterectomy when she was 45, she's 63 now. She had one of her ovaries removed and has been dx's with osteo just recently.
It really does sound like there is a link.
I've just started wondering about this wonderful time of life. I'm 49 and am still as regular as clockwork. My GP won't bother doing hormone levels because she says if I still have periods the hormone levels will just fluctuate and not tell much. My problem is my iron levels. I'm wondering if they will settle once things finally stop, whenever that might be. I suppose if things run true to form I will Never get Dementia or Parkinsons. I have never considered HRT, I've had hot flashes and night sweats but I don't know whether they are related to the RA or hormones. I've tried some natural tablets for the hot flashes and they seemed to work but I still have the sweats sometimes, possibly when I'm flaring. I don't know. When would you normally start HRT, after periods stop? As they are stopping? And how long would you normally remain on HRT?
No answers here, just questions.
Pip, I'm with you. I feel very strongly that HRT is helpful in more ways than one just because of my own miserable experiences. I was always the picture of health until my mid 40s when I started having nerve pain, achy knees, terrible overall stiffness in the morning and painful joints, plus panic attacks. I never put 2 and 2 together until I was started on birth control pills to control night sweats and lo and behold, all the other problems went away too. Later I was put on lower HRT doses and each time the dose was lowered the symptoms came back, but not as bad as before HRT. Most recently I asked to drop my estrogen because I worry about breast cancer, but when I did, that's when the muscle spasms and joint pain came back in full force. My RD doesn't think there's a link because my blood work suggests autoimmune issues, but it's too much of a coincidence. I told him I could probably get rid of all my problems (except for the left-sided pain and weakness which doesn't respond to anything so far) by going back on a higher dose of estradiol but since some of my problems are helped by the Plaq. and MTX he's still not convinced I'm right. This hormone business really confuses the issue for women, no question. All I know is, when I was on BC pills I felt like a 20 year old again. Of course it's not safe to take hormones at that high dose anymore at my age (55), but it's clear to me that hormones help some of us.Pammy -
I have no idea when you're supposed to start this stuff. I figured I'd get some sort of sign to start researching yet another thing. LOL I do know I never did PMS - and now I do. Hmmmmm. Maybe I should start looking into it sooner rather than later.
Jesse - and All - check this out. I found this today.
http://www.topix.net/content/trb/2007/06/estrogen-replacemen t-safe-for-most-women-study-finds
Pip
I had my hormone blood levels pulled when I had my first pre-menopausal symptoms. When I finally turned menopausal, I had baseline blood numbers to work with and was immediately put on HRT, which I was going to do for 2 years for the osteo, but stopped at 18 months because I thought the HRT was making me sick. But it was really the accelerating in my MCTD symptoms that were still vague and undiagnosed, as I hadn't realized I was falling ill. I, too, am a big believer in HRT for the first two years of menopause, surprising because of my in-utero with my DES exposure, I don't think more estrogen is good for a body poisoned by estrogen.
Here is the only joke I have ever made up all by myself:
"Short-term memory loss is a symptom of perimenopause, but I keep forgetting that" ...
Justsay, good joke, wish I was clever enough to make one up on my own.
I also was a DES baby and it never occurred to me that it would figure into my HRT choices now. I was told a couple of years ago by my doctor that I'm past the age of worry about DES exposure. If anything was going to happen because of the DES, it would have happened well before I hit my 50s. Hmmmm. Did he even consider how it affects HRT? Another fly in the ointment with this DES/HRT link.
I had a complete hysterectomy two years ago this last June. I was having a horrid time with my monthy's. I had extreme PMS, in constant pain. I had one week a month where I felt good. My gyno finally told me to consider a hysterectomy. I gladly agreed. I decided not to go the hormone route. I was covered with endometriosis. And was told it would make it worse, as it had spilled outside my uterus onto my kidneys, bladder and such. I also had a tumor that had grown from my left overy, into my left tube and onto my bowels, (sorry so graphic). Which my Gyno said was causing alot of my pain... Also my Aunt made me promise that if I didn't have to go on hormone therapy not to, as it was the reason she ended up with breast cancer. She was on hormones for years. Of course I was older too, when I had my hysterectomy, I was 48. So none of this probably relates to me since I was older.
So I guess I'm not sure if my hysterectomy, and no hormonys brought on my RA. Or if it was just in the cards for me. I also heard that long term stress can help bring on RA. Don't know if that is true or not. I do know these last few years have been quite stressful for me and my family.
Jessee, in 1988 a connection was made between in-utero DES babies who had probably a low exposure amount and didnt die of the cancer by age thirty, of developing autoimmune disease. There are hints that menopause also plays into the autoimmune/DES exposure, but no hard evidence yet (just our reality). There is a whole generation of us ticking timebombs going off all over America, daily, and a bunch of bewildered doctors.
I had a full hysterectomy due to endometriosis, which I had so bad that it was found in my bowels, intestines, and even sinuses, myovaries and tubes were literally wrapped together with the endo, the dr is stilltrying to figure out how I ever had my daughter. MY ovaries were removed due to this and I was only placed on estrogen replacement for 2 months and then removed from it, because of the endometriosis, You see if there is one itty bitty piece left of the endo it can spread again from the estrogen replacement, and because I had the endo so bad the drs felt it was better to go without the estrogen replacement. This was done when I was 41 and I am now 50. I have been doing fine, but then I also make sure I take vitamins etc. and exercise too. I am checked regularly to see if there is any problems from not taking hromone replacement, but everything is looking good. I have ra, oa and pa, but I feel I was prone to them because it runs in the family. memeJustsay, thanks for that very interesting information. My oldest sister, 71, who was not exposed to DES and has been on hormone replacement since her late 40s, developed raging RA at age 62. I've developed a milder, less definitive version at 55, with DES exposure. Middle sister, 65, no DES, some hormone replacement, no RA. I'm certainly glad to know of the possible DES/autoimmune link. Knowledge is power. Guess I'd better ask my OB/GYN what she thinks about the DES/HRT issue, although, like you said, they are a bewildered bunch when it comes to some hard-to-track-down health issues. Guess we're pretty much on our own, huh? I had one ovary left in and I have been told (not sure if this is true) that most
often the left over ovary dies within a year so it basically puts you into a
surgical menopause. I have noticed some menopausal symptoms and I went
with the vaginal estrogen 2x a week. I'm a bit scared of it as I have enough
fat tissue to make plenty of estrogen.
I recently was reading about Natural Hormone replacement and its advantages over patented Hormone Replacement like Premarin/Provera.
Here is the title of the book and the author.
Pip
Just, my mom died many years ago at age 76 from Alzheimer's. As you may know, there was some discussion of HRT first helping to prevent Alz. and then a reversal that says it may trigger it. This, obviously is a concern for me and many women who have close relatives who died with Alz. As far as I know, my mom didn't suffer any ill effects from the DES. What did your mom die from and how was the DES responisible? This is interesting but a little scary too.
Pip, never heard of that medication. Maybe someone else here can enlighten us.
Yeah, my friend jumped thru hopes and she loves it! Just so many people on the board mention Thyroid issues and...well, I gonna read the book Thyme (?) suggested above.
Pip
Jesse - she died of the fast moving pancreatic cancer that Michael Langdon and the Cardinal died of. But, when we go back through pictures, I was the last of three children, and she just never got her good health back after taking the DES for my gestation. We can never prove it, but its just been a family observation. The part that is hard for me is that I suffered for many years with right side abdominal pain, which was put down to mild IBS with no treatment. I finally pulled my records from Cleveland Clinic in Naples, Florida, and the next doctor pulled an amylase and lipase blood test (first time) and I was suffering from severe acute pancreatitis attacks with no help. And pancreatic cancer is hereditary so it was a big scare. But it came down to an infected, inflammed gall bladder and the pancreatitis cleared up after its removal. Then I was given Zelnorm for the IBS ... Jesse, you should check out DES under the Center for Disease Control - they are starting to throw some money at this slight problem - it was outlawed finally in 1994, but doctors kept prescribing DES-based pre-natal vitamins until 1997 :(
PS to stay on-topic - I haven't had a hysterectomy, but I also FORGOT to have children. That's not true, I decided not to reproduce because DES changes your DNA (first drug to do so) and its passed down to your children.
Wow, you've really been through the mill on this DES thing. The good thing is you're very informed and on top of it. I'll check out the CDC for more DES information. Thanks for the heads up.
Gotta go. Neighborhood association meeting at 12:00. It's going to be a bad one!!!
Jesse88 Arbonne makes a bio-identical cream for progesterone (sp)? They have an excellent reputation. And you won't have to choke down a pill any more.Now I know the real reason I'm nuts, and I thought it was my teenagers!! LOLJesse , The book talks about 3 different types of estrogen we have in our bodies and they use the term bio-identical. They also say if you go to a compounding pharmacy they can make them into capsules, creams or patches. So what ever works best for you. Do you currently get your prometrium from a compounding pharmacy?
Here is a link to finding compounding pharmacies in the US.
http://www.angelfire.com/fl/endohystnhrt/pharmacy.html
thyme. I also wanted to add that you can do a saliva test to determine how
It is so difficult as a woman to know what to do about hysterectomy and/or HRT. I am at a loss. I have fibroids that are growing, and my suspension system is shot
But I just don't want to be without my hormones. HRT would be a difficult choice for me - my mother was on it and developed breast cancer, and I have a strong history of heart disease in my family. So I'm keeping what I've got for now.
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