If I have my ovaries removed before I'm 50, will I be more likely to have dementia when I get older?
Answer From Jonathan Graff-Radford, M.D.
You might, but more research is needed to know for sure. Ovary removal (oophorectomy), often done in conjunction with a hysterectomy, has a dramatic effect on your body before menopause. This abrupt loss of your ovaries is also called surgical menopause, because it triggers all the changes of menopause.
Your ovaries produce most of your body's estrogen, a reproductive hormone that has many functions beyond regulating your menstrual cycle. Estrogen may protect your brain from age-related changes that can lead to cognitive impairment and dementia.
Some studies have suggested that an early oophorectomy may increase your risk of Alzheimer's disease, other types of dementia or cognitive decline. Some research suggests that you may help offset this risk by taking hormone therapy (HT) until you reach a natural age of menopause.
More research will be needed before doctors can know for sure whether an oophorectomy will increase your risk of dementia and whether HT is necessary.
That's why it's important to talk with your doctor before deciding to have an oophorectomy.
Ask your doctor:
- What condition the surgery is treating
- What other treatment options there are
- Whether you're close to menopause
- Whether you'll be a candidate for HT
For some women, an oophorectomy is worth the long-term risks. If you carry one of the genetic mutations that make you likely to develop breast and ovarian cancers, for example, this surgery may save your life — even if you don't take HT.
Sept. 12, 2017
Jonathan Graff-Radford, M.D.
See more Expert Answers
- Siyam T, et al. The effect of hormone therapy on quality of life and breast cancer risk after risk-reducing salpingo-oophorectomy: A systematic review. BMC Women's Health. 2017;17:22.
- Podfigurna-Stopa A, et al. Premature ovarian insufficiency: The context of long-term effects. Journal of Endocrinological Investigation. 2016;39:983.
- Ovarian shutdown or removal. Breastcancer.org. http://www.breastcancer.org/treatment/hormonal/ovary_removal. Accessed July 21, 2017.
- Bove R, et al. Age at surgical menopause influences cognitive decline and Alzheimer pathology in older women. Neurology. 2014;82:222.
- Graff-Radford J (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 28, 2017.
- Reed SD, et al. Elective oophorectomy or ovarian conservation at the time of hysterectomy. https://www.uptodate.com/contents/search. Accessed July 18, 2017.
- Martin KA, et al. Menopausal hormone therapy: Benefits and risks. https://www.uptodate.com/contents/search. Accessed July 19, 2017.
- Rocca WA, et al. Sex and gender differences in the causes of dementia: A narrative review. Maturitas. 2014;79:196.