Objective: We studied the long-term risk of depressive and anxiety symptoms in women who underwent bilateral oophorectomy before menopause. Design: We conducted a cohort study among all women residing in Olmsted County, MN, who underwent bilateral oophorectomy before the onset of menopause for a noncancer indication from 1950 through 1987. Each member of the bilateral oophorectomy cohort was matched by age with a referent woman from the same population who had not undergone an oophorectomy. In total, we studied 666 women with bilateral oophorectomy and 673 referent women. Women were followed for a median of 24 years, and depressive and anxiety symptoms were assessed using a structured questionnaire via a direct or proxy telephone interview performed from 2001 through 2006. Results: Women who underwent bilateral oophorectomy before the onset of menopause had an increased risk of depressive symptoms diagnosed by a physician (hazard ratio=1.54, 95% CI: 1.04-2.26, adjusted for age, education, and type of interview) and of anxiety symptoms (adjusted hazard ratio=2.29, 95% CI: 1.33-3.95) compared with referent women. The findings remained consistent after excluding depressive or anxiety symptoms that first occurred within 10 years after oophorectomy. The associations were greater with younger age at oophorectomy but did not vary across indications for the oophorectomy. In addition, treatment with estrogen to age 50 years in women who underwent bilateral oophorectomy at younger ages did not modify the risk. Conclusions: Bilateral oophorectomy performed before the onset of menopause is associated with an increased long-term risk of depressive and anxiety symptoms.
Bibliographical noteFunding Information:
Received November 16, 2007; revised and accepted March 17, 2008. From the Divisions of 1Epidemiology and 2Biostatistics, Department of Health Sciences Research; Departments of 3Psychiatry and Psychology, 4Obstetrics and Gynecology, and 5Neurology, College of Medicine, Mayo Clinic, Rochester, MN. Funding/support: This work was funded by the National Institute of Neurological Disorders and Stroke grant NS33978 and the National Institute of Arthritis and Musculoskeletal and Skin Diseases grant AR30582. Yonas E. Geda was supported in part by the National Institute of Mental Health grant MH68351. Financial disclosure: None reported. Address correspondence to: Walter A. Rocca, MD, MPH, Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E-mail: firstname.lastname@example.org DOI: 10.1097/GME.0000000000001229 Menopause 2008;15:1050-1059. Reprinted with permission.
- Age at menopause
- Anxiety symptoms
- Cohort study
- Depressive symptoms
- Estrogen treatment