Advertisement

Longevity after early surgical menopause—the long-term effect of a permanent cessation of reproductive function and female sex hormone loss

      Abstract

      Objective: To investigate longevity in women after bilateral salpingo-oophorectomy (BSOE), not given hormonal replacement therapy (HRT) post-operatively, as compared to the national mean. Study design: Long-term follow-up study of a historical cohort of young women undergoing BSOE in the early 20th century at the General Hospital, Malmö, Sweden. Comparison was made with mean life expectancy in corresponding birth cohorts. Results: No difference in life expectancy was recorded in 152 women with an early menopause caused by BSOE and not substituted with HRT, as compared to national statistics of contemporary women. Half of the operated women died of cardiovascular disease and a minority of cancer, none of which was a breast cancer. Conclusion: Permanent loss of female sex hormones and reproductive function in early life does not seem to influence longevity but may change patterns of morbidity and mortality.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

        • Rosenberg L.
        • Hennekens C.H.
        • Rosner B.
        • Belanger C.
        • Rothmann K.J.
        • Speizer F.E.
        Early menopause and the risk of myocardial infarction.
        Am. J. Obstet. Gynecol. 1981; 139: 47-51
        • Colditz G.A.
        • Willett W.C.
        • Stampfer M.J.
        • Rosner B.
        • Speizer F.E.
        • Hennekens C.H.
        Menopause and the risk of coronary heart disease in women.
        N. Engl. J. Med. 1987; 316: 1105-1110
        • van der Schouw Y.T.
        • van der Graaf Y.
        • Steyerberg E.W.
        • Eijkemans M.J.C.
        • Banga J.D.
        Age at menopause as a risk factor for cardiovascular mortality.
        Lancet. 1996; 347: 714-718
        • Falkeborn M.
        • Schairer C.
        • Naessén T.
        • Persson I.
        Risk of myocardial infarction after oophorectomy and hysterectomy.
        J. Clin. Epidemiol. 2000; 53: 832-837
        • Nilsson P.
        • Möller L.
        • Köster A.
        • Hollnagel H.
        Social and biological predictors of early menopause—a model for premature ageing.
        J. Intern. Med. 1997; 242: 299-305
        • Parrish H.M.
        • Carr C.A.
        • Hall D.G.
        • King T.M.
        Time interval from castration in pre-menopausal women to development of excessive coronary atherosclerosis.
        Am. J. Obstet. Gynecol. 1967; 99: 155-162
        • Roberts W.C.
        • Giraldo A.A.
        Bilateral oophorectomy in menstruating women and accelerated coronary atherosclerosis: an unproved connection.
        Am. J. Med. 1979; 67: 363-365
        • Ask-Upmark E.
        Life and death without ovaries.
        Acta Med. Scand. 1962; 172: 129-135
        • Johannson B.W.
        • Laij L.
        • Kullander S.
        • Lennér H.-C.
        • Svanberg L.
        • Åstedt B.
        On some late effects of bilateral oophorectomy in the age range 15–30 years.
        Acta Obstetr. Gynecol. Scand. 1975; 54: 449-461
        • Svanberg L.
        Effects of estrogen deficiency in women castrated when young.
        Acta Obstetr. Gynecol. Scand. 1981; 106: 11-15
        • Westendorp R.G.
        • Kirkwood T.B.
        Human longevity at the cost of reproductive success.
        Nature. 1998; 396: 743-746
        • Schairer C.
        • Persson I.
        • Falkeborn M.
        • Naessen T.
        • Troisi R.
        • Brinton L.A.
        Breast cancer risk associated with gynecologic surgery and indications for such surgery.
        Int. J. Cancer. 1997; 70: 150-154
      1. Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy post-menopausal women: principal results from the Women’s Health Initiative Randomized Controlled Trial. JAMA 2002;288:321–33.