Elsevier

Mayo Clinic Proceedings

Volume 91, Issue 11, November 2016, Pages 1577-1589
Mayo Clinic Proceedings

Original article
Accelerated Accumulation of Multimorbidity After Bilateral Oophorectomy: A Population-Based Cohort Study

https://doi.org/10.1016/j.mayocp.2016.08.002Get rights and content
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Abstract

Objective

To study the association between bilateral oophorectomy and the rate of accumulation of multimorbidity.

Patients and Methods

In this historical cohort study, the Rochester Epidemiology Project records-linkage system was used to identify all premenopausal women who underwent bilateral oophorectomy before age 50 years between January 1, 1988, and December 31, 2007, in Olmsted County, Minnesota. Each woman was randomly matched to a referent woman born in the same year (±1 year) who had not undergone bilateral oophorectomy. We studied the rate of accumulation of 18 common chronic conditions over a median of approximately 14 years of follow-up.

Results

Although women who underwent bilateral oophorectomy already had a higher multimorbidity burden at the time of oophorectomy, they also experienced an increased risk of subsequent multimorbidity. After adjustments for 18 chronic conditions present at baseline, race/ethnicity, education, body mass index, smoking, age at baseline, and calendar year at baseline, women who underwent oophorectomy before age 46 years experienced an increased risk of depression, hyperlipidemia, cardiac arrhythmias, coronary artery disease, arthritis, asthma, chronic obstructive pulmonary disease, and osteoporosis. In addition, they experienced an accelerated rate of accumulation of the 18 chronic conditions considered together (hazard ratio, 1.22; 95% CI, 1.14-1.31; P<.001). Several of these associations were reduced in women who received estrogen therapy.

Conclusion

Bilateral oophorectomy is associated with a higher risk of multimorbidity, even after adjustment for conditions present at baseline and for several possible confounders. However, several of these associations were reduced in women who received estrogen therapy.

Abbreviations and Acronyms

DHHS
Department of Health and Human Services
ET
estrogen therapy
HR
hazard ratio
ICD-9
International Classification of Diseases, Ninth Revision
MOA-2
Mayo Clinic Cohort Study of Oophorectomy and Aging
REP
Rochester Epidemiology Project

Cited by (0)

Grant Support: This study was made possible by the Rochester Epidemiology Project (grant number R01-AG034676; Principal Investigators: Walter A. Rocca, MD, MPH, and Jennifer L. St. Sauver, PhD). The study was also supported in part by funds from the Mayo Clinic Research Committee (W.A.R.) and grants P50 AG044170, U01 AG006786, P01 AG004875 (W.A.R.), and P50 AG044170 (V.M.M.) from the National Institutes of Health.

Potential Competing Interests: Dr Stewart has received fees for serving on the advisory board of Gynesonics, consulting fees from AbbVie Inc, Bayer AG, GlaxoSmithKline, Astellas Pharma Inc, Welltwigs, Viteava Pharmaceuticals Inc, and Allergan Plc, and has a patent (US 6440445) for methods and compounds for treatment of abnormal uterine bleeding.