Family history of heart disease makes premature removal of ovaries especially risky

Women who proactively have their ovaries removed to minimize their cancer risk may face a greater risk—premature death because of heart disease. That's according to a new study that identifies an increased risk for women with a family history of premature heart disease who underwent prophylactic oophorectomies before the age of 45. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

There has been ongoing debate in the medical community as to whether the surgical removal of the ovaries when performed earlier than age 45 years, alters a woman's exposure to endogenous ovarian hormones, effectively increasing her risk of heart disease. Multiple studies have suggested that women who undergo bilateral salpingo-oophorectomy (removal of the fallopian tubes and both ovaries) before the time of natural menopause have a greater risk of cardiovascular disease than women of similar age with intact ovaries.

In this study based on data from more than 2,700 postmenopausal women, researchers specifically investigated the modifying effects of family history of premature myocardial infarction (before the age of 50 years) on the association between removal of the ovaries before the age of natural menopause and mortality attributed to heart and cardiovascular disease. Their findings showed that such family history definitely elevated the risk of heart disease mortality in women who had both ovaries removed before the age of 45.

These findings have broad, mainstream relevance as ovaries are, unfortunately, the most frequently removed healthy organ for preventive purposes. Currently, more than half of women undergoing hysterectomy for benign conditions also undergo bilateral salpingo-oophorectomy. This study underscores the importance of considering potential risks before choosing to remove normal ovaries in young women.

Study results appear in the article "Family history of premature myocardial infarction modifies the associations between bilateral oophorectomy and cardiovascular disease mortality in a US national cohort of postmenopausal women."

"This study provides additional evidence that removal of the ovaries before the natural age of menopause is associated with multiple adverse long-term health outcomes, including cardiovascular disease and early mortality and should be strongly discouraged in women who are not at increased genetic risk for ovarian cancer," says Dr. Stephanie Faubion, NAMS medical director.